KASMEJ
Kastamonu Medical Journal

Kastamonu Medical Journal regularly publishes internationally qualified issues in the field of Medicine in the light of up-to-date information.

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Original Article
The role of immature granulocytes in the early diagnosis of pneumonia developing secondary to rib fractures
Abstract
Aims: This retrospective study aimed to investigate the role of immature granulocytes (IGs) in the early diagnosis of pneumonia secondary to rib fractures.
Methods: This study was conducted on patients who applied to the emergency department of our hospital between 2019 and 2022. Patients aged between 18 and 100 years who were found to have rib fractures in the thorax CT report and were hospitalized, who had hemogram data in the hospital’s database, were included in the study. Patients with detected COVID-19 infection without hemogram data and patients who refused examination and treatment were excluded from the study. Patients’ blood tests, radiological images, and epicrisis reports were analyzed. The data of patients with and without pneumonia were compared statistically.
Results: Overall, 155 patients, 117 men and 38 women were included in the study. Pneumonia developed in 11 patients, and two patient died. In our study, it was determined that the risk of pneumonia increased by 38% in each additional rib fracture, and the risk of pneumonia increased 9.44 times if the IG value at the 48th hour was greater than 0.06. In addition, when the receiver operating characteristic curves in our study were examined, it was observed that the IG number at 48 hours gave excellent results in the diagnosis of pneumonia, with 75% sensitivity and 88% specificity (cut off: 0.055, AUC: 0.827, p = 0.002).
Conclusion: Our study showed that IGs are an effective marker in the early diagnosis of pneumonia secondary to rib fractures.

Keywords : Rib fracture, pneumonia, immature granulocytes, CRP

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1. Kasotakis G, Hasenboehler EA, Streib EW, et al. Operative fixation of rib fractures after blunt trauma: a practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2017;82(3):618-626. doi: 10.1097/TA.0000000000001350
2. Brasel KJ, Guse CE, Layde P, Weigelt JA. Rib fractures: relationship with pneumonia and mortality. Crit Care Med. 2006;34(6):1642-1646.
3. Bulger EM, Arneson MA, Mock CN, Jurkovich GJ. Rib fractures in the elderly. J Trauma. 2000;48(6):1040-1046. doi: 10.1097/00005373-200006000-00007
4. Wright Wr. Atelectasis. Can Med Assoc J. 1950;62(3):238-240.
5. Frings DP, Montag B, Heydorn A, Friedemann M, Pothmann W, Nierhaus A. Proceedings of the 16th Annual Congress of the European Society of Intensive Care Medicine (ESICM ‘03) October 2003. Immature granulocytes, immature myeloid cells and outcome in adult severe sepsis and septic shock. Amsterdam, Netherlands.
6. Iddles C, Taylor J, Cole R, et al. Evaluation of immature granulocyte count in the diagnosis of sepsis using the Sysmex XE-2100 analyser. Sysmex J Int. 2007;17(1):20-29.
7. Balamurugan S, Treshul K, Jayapria S, Jeya M, Ramesh RK. Automated measurement of immature granulocytes: performance characteristics and utility in routine clinical practice. Pathol Res Int. 2012;2012:483670.
8. Shorr RM, Rodriguez A, Indeck MC, Crittenden MD, Hartunian S, Cowley RA. Blunt chest trauma in the elderly. J Trauma. 1989;29(2):234-237. doi: 10.1097/00005373-198902000-00016
9. Suszczyk D, Skiba W, Jakubowicz-Gil J, Kotarski J, Wertel I. The role of myeloid-derived suppressor cells (MDSCs) in the development and/or progression of endometriosis-state of the art. Cells. 2021;10(3):677. doi: 10.3390/cells10030677
10. Daix T, Jeannet R, Hernandez Padilla AC, Vignon P, Feuillard J, François B. Immature granulocytes can help the diagnosis of pulmonary bacterial infections in patients with severe COVID-19 pneumonia. J Intensive Care. 2021;9(1):58. doi: 10.1186/s40560-021-00575-3
11. Nierhaus A, Klatte S, Linssen J, et al. Revisiting the white blood cell count: immature granulocytes count as a diagnostic marker to discriminate between SIRS and sepsis--a prospective, observational study. BMC Immunol. 2013;14:8. doi: 10.1186/1471-2172-14-8
12. Bedel C, Korkut M, Selvi F. New markers in predicting the severity of acute pancreatitis in the emergency department: immature granulocyte count and percentage. J Postgrad Med. 2021;67(1):7-11. doi: 10.4103/jpgm.JPGM_784_20
13. Güngör A, Göktuğ A, Güneylioğlu MM, et al. Utility of biomarkers in predicting complicated appendicitis: can immature granulocyte percentage and C-reactive protein be used?. Postgrad Med. 2021;133(7):817-821. doi: 10.1080/00325481.2021.1948306
14. Beks RB, Peek J, de Jong MB, et al. Fixation of flail chest or multiple rib fractures: current evidence and how to proceed. A systematic review and meta-analysis. Eur J Trauma Emerg Surg. 2019;45(4):631-644. doi: 10.1007/s00068-018-1020-x
Article available in :
Volume 4, Issue 3, 2024
Page : 84-87
https://doi.org/10.51271/KMJ-0149
Article Information
Received : 16 Nis 2024
Accepted : 11 Haz 2024
Published : 01 Eyl 2024
Corresponding Author :

İsmail Dal: Department of Thoracic Surgery, Faculty of Medicine, Kastamonu University, Kastamonu, Turkiye

[email protected]
Citation : Dal İ, Gülten S. The role of immature granulocytes in the early diagnosis of pneumonia developing secondary to rib fractures. Kastamonu Med J. 2024;4(3):84-87.

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