Systemic inflammatory markers for distinguishing uncomplicated and complicated acute appendicitis in adult patients.

IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL
Secil Yesilalioglu, Adem Az, Ozgur Sogut, Huseyin Ergenc, Ilhami Demirel
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Abstract

Objective: This study aimed to investigate the predictive power of serum systemic inflammatory markers including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-eosinophil ratio (MER), and C-reactive protein (CRP) levels for distinguishing uncomplicated and complicated acute appendicitis in adult patients admitted to the emergency department (ED).

Methods: This retrospective, cross-sectional, observational, and single-center study enrolled 212 consecutive adult patients with acute appendicitis who were admitted to the ED of our tertiary care university hospital between January 1, 2019 and December 31 2021. Patients were divided into two groups (Group I, uncomplicated acute appendicitis; Group II, complicated appendicitis) according to their surgical findings and histopathological examination. Systemic inflammatory markers measured on admission were compared among patients to identify factors associated with complicated acute appendicitis.

Results: A total of 132 patients, 83 male (62.9%) and 49 female (37.1%), were included in the study. The mean age was 34.7±13.40 years. Based on the histopathological examination, the number of patients in Group I was 103 (78.03%) and 29 (21.96%) in Group II. Laboratory findings on admission revealed no significant differences between Groups I and II patients in terms of mean serum NLR, MER, and CRP values (p=0.096, p=0.248, and p=0.297, respectively). However, the mean serum PLR in Group II patients was statistically significantly higher than those in Group I (p=0.032). The mean serum monocyte and monocyte fraction (%) values were significantly lower, and the mean serum neutrophil fraction (%) value was higher in Group II patients compared to those with Group I. Receiving operator characteristic (ROC) analysis identified a serum PLR cutoff value of ≥133.73 for distinguishing uncomplicated and complicated acute appendicitis in adult patients, with 60% sensitivity and 58.4% specificity. In addition, ROC analysis revealed a cutoff monocyte fraction (%) level of ≤6, with 72% sensitivity and 64% specificity, for distinguishing uncomplicated and complicated acute appendicitis in adult patients.

Conclusion: Our findings indicate that the mean serum NLR, MER, and CRP values measured on admission to ED in adult patients with acute appendicitis could not predict complicated acute appendicitis. However, mean serum PLR and neutrophil and monocyte counts can be useful in distinguishing complicated cases.

Abstract Image

Abstract Image

成人急性阑尾炎单纯性与复合性的全身炎症标志物鉴别。
目的:本研究旨在探讨血清系统性炎症标志物,包括中性粒细胞-淋巴细胞比率(NLR)、血小板-淋巴细胞比率(PLR)、单核细胞-嗜酸粒细胞比率(MER)和c反应蛋白(CRP)水平对急诊科(ED)成年患者非并发症和并发症急性阑尾炎的预测能力。方法:这项回顾性、横断面、观察性、单中心研究纳入了2019年1月1日至2021年12月31日在我们三级医院急诊科收治的212例连续急性阑尾炎成年患者。患者分为两组(I组,无并发症急性阑尾炎;II组,复杂性阑尾炎),根据手术表现和组织病理学检查。对入院时测量的全身炎症标志物进行比较,以确定与复杂急性阑尾炎相关的因素。结果:共纳入132例患者,其中男性83例(62.9%),女性49例(37.1%)。平均年龄34.7±13.40岁。经组织病理学检查,ⅰ组103例(78.03%),ⅱ组29例(21.96%)。入院时的实验室检查结果显示,I组和II组患者在平均血清NLR、MER和CRP值方面无显著差异(p=0.096、p=0.248和p=0.297)。然而,II组患者的平均血清PLR高于I组(p=0.032)。与ⅰ组相比,ⅱ组患者血清单核细胞和单核细胞分数(%)平均值明显降低,血清中性粒细胞分数(%)平均值较高。接受操作者特征(ROC)分析发现,血清PLR截断值≥133.73可用于区分成人急性阑尾炎的单纯性和复杂性,敏感性为60%,特异性为58.4%。此外,ROC分析显示,单核细胞分数(%)水平≤6,敏感性72%,特异性64%,可用于区分成人急性阑尾炎的单纯性和复杂性。结论:我们的研究结果表明,成年急性阑尾炎患者入院时测量的平均血清NLR、MER和CRP值不能预测并发症的急性阑尾炎。然而,平均血清PLR、中性粒细胞和单核细胞计数在区分复杂病例时是有用的。
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来源期刊
Northern Clinics of Istanbul
Northern Clinics of Istanbul MEDICINE, GENERAL & INTERNAL-
CiteScore
0.40
自引率
0.00%
发文量
48
审稿时长
10 weeks
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