Evaluation of Hematological Inflammatory Indices and Aspartate Aminotransferase to Platelet Ratio Index in Relation to Diagnosis and Length of Hospital Stay in Patients with Hyperemesis Gravidarum
DOI:
https://doi.org/10.58600/eurjther2795Keywords:
aspartate aminotransferases, hyperemesis gravidarum, inflammatory markers, neutrophil-to-lymphocyte ratioAbstract
Objective: This study aimed to evaluate the diagnostic and prognostic value of systemic inflammatory indices and the Aspartate Aminotransferase-to-Platelet Ratio Index (APRI) score in patients diagnosed with hyperemesis gravidarum (HG) and to investigate their association with the length of hospital stay.
Methods: A total of 210 pregnant women were included, comprising 105 patients with HG and 105 healthy controls, matched based on maternal age, gravida, parity, number of previous abortions, and gestational age. Inflammatory indices including the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), pan-immune-inflammation value (PIV), and Aspartate Aminotransferase-to-Platelet Ratio Index (APRI) were compared between groups. Receiver operating characteristic (ROC) analysis, univariable, and multivariable logistic regression were performed to assess diagnostic performance and predictors of prolonged hospitalization (≥2 days).
Results: All inflammatory indices were significantly elevated in the HG group (p < 0.001). NLR showed the highest diagnostic performance (area under the curve [AUC] = 0.83). MLR remained statistically significant in the multivariable model (p = 0.023), although the effect size was small and the confidence interval wide. Although several indices were associated with HG diagnosis, none independently predicted prolonged hospitalization. Ketonuria was the only variable significantly associated with a hospital stay of ≥2 days (odds ratio [OR] = 1.862, 95% CI: 1.077–3.220, p = 0.026). APRI was also significantly elevated in HG patients; this represents its first evaluation in this context.
Conclusion: Systemic inflammatory indices may assist in the diagnostic evaluation of HG but appear to have limited prognostic value for hospital stay duration. Ketonuria remains a more reliable indicator of disease severity. The observed elevation of APRI should be interpreted with caution, as supporting hepatic imaging and biochemical markers were not included, and requires further validation in future prospective studies.
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Copyright (c) 2025 İbrahim Taşkum, Selcan Sınacı, Seyhun Sucu, Erkan Yergin, Necd Makansi, Murat Günenç, Eda Cennet Şahan
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