The predictive effect of initial complete blood count of intensive care unit patients on mortality, length of hospitalization, and nosocomial infections.

OBJECTIVE: The mean platelet volume (MPV) can be used as an indicator of platelet activation. However, it has been shown that the platelet/lymphocyte ratio (PLR) can provide useful predictive information about inflammation and aggregation pathways. The neutrophil/lymphocyte ratio (NLR) may also be helpful as a marker of systemic or local inflammation. The main objective of this study evaluated to unselected critically ill patients the relationship of initial MPV, NLR, and PLR with mortality, length of hospitalization, and the risk of developing nosocomial infections in ICU patients. PATIENTS AND METHODS: In this retrospective study, we evaluated consecutive patients at our tertiary nine-bed ICU. One hundred seventy-three patients who were followed up during a 1-year period were included. RESULTS: MPV levels were found to be higher in patients who died in the hospital (p = 0.05). In addition, there was a significant positive correlation between expected mortality rate and MPV among non-survivors (p = 0.009). NLR levels were higher among non-survivors, but this difference was not statistically significant (p = 0.435). PLR levels were similar between non-survivors and survivors (p = 0.173). The initial NLR and PLR were significantly higher in patients with nosocomial infections. NLR and PLR had a significant positive correlation with length of hospitalization (p = 0.006 and p = 0.027, respectively). CONCLUSIONS: In our study, we found that high PLR and NLR may be indicators for the development of nosocomial infections. Moreover, the length of hospitalization may be prolonged in patients with high PLR and NLR.

Fusiform basilar artery aneurysm rapid death with occlusion and subdural-subarachnoid hemorrhage.

Fusiform aneurysms of the posterior circulation constitute a relatively uncommon subgroup of aneurysms. We present a patient with fusiform basilar artery aneurysm accompanied by ectasia and elongation of both supraclinoid parts of the internal carotid arteries, middle cerebral arteries and vertebral arteries. The aneurysm had thrombus formation along its length which progressed to occlude the lumen the day after the patient's admission. Mass effect, progressive infarcts at the territories of posterior inferior cerebellar (PICA) and superior cerebellar (SCA) arteries and brainstem perforators along with subarachnoid and subdural hemorrhage were present.