ABSTRACT

Background

Acute appendicitis is the most common reason for abdominal surgery in children. The aim of this study was to evaluate the utility of biomarkers in predicting complicated appendicitis (CA).

Methods

Patients having a diagnosis of acute appendicitis who underwent operations were retrospectively determined, and the utility of biomarkers in predicting CA was evaluated.

Results

A total of 251 patients were included in the study. The mean age was 130.9 ± 48.8 months, 148 of the cases (59%) were simple appendicitis, and 103 (41%) were CA. The C-reactive protein (CRP) levels, immature granulocyte (IG) percentage, white blood cell counts, and absolute neutrophil counts were significantly higher in the CA patients. The bilirubin levels and neutrophil to lymphocyte ratios were not useful for predicting CA. The best area under the curve (AUC) values to predict CA were with the IG percentage and CRP level (0.82), the IG percentage [odds ratio (OR) 9.36, 95% CI (4.94–17.75), p < 0.001] and CRP [OR 8.42, 95% CI (4.72–15.02), p < 0.001] were the best marker in predicting CA. The sensitivity of the IG percentage and CRP level were higher than other markers.

Conclusion

To predict CA, the best AUC values were associated with the IG percentage and the CRP level. Because it is easy, fast to measure, does not require taking extra blood, and does not lead to additional costs, IG percentage may be preferred in the diagnosis of patients with CA.

中文翻译：

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生物标志物在预测复杂性阑尾炎中的效用：可以使用未成熟粒细胞百分比和 C 反应蛋白吗？

摘要

背景

急性阑尾炎是儿童腹部手术最常见的原因。本研究的目的是评估生物标志物在预测复杂性阑尾炎 (CA) 中的效用。

方法

回顾性确定接受手术的诊断为急性阑尾炎的患者，并评估生物标志物在预测 CA 中的效用。

结果

共有 251 名患者被纳入研究。平均年龄为 130.9 ± 48.8 个月，其中 148 例（59%）为单纯性阑尾炎，103 例（41%）为 CA。CA 患者的 C 反应蛋白 (CRP) 水平、未成熟粒细胞 (IG) 百分比、白细胞计数和绝对中性粒细胞计数显着升高。胆红素水平和中性粒细胞与淋巴细胞的比率对预测 CA 没有用处。预测 CA 的最佳曲线下面积 (AUC) 值是 IG 百分比和 CRP 水平 (0.82)、IG 百分比 [优势比 (OR) 9.36, 95% CI (4.94–17.75), p < 0.001 ] 和CRP [OR 8.42, 95% CI (4.72–15.02), p < 0.001 ] 是预测 CA 的最佳指标。IG百分比和CRP水平的敏感性高于其他标志物。

结论

为了预测 CA，最佳 AUC 值与 IG 百分比和 CRP 水平相关。因为它易于测量、快速测量、不需要额外采血并且不会导致额外费用，所以 IG 百分比在 CA 患者的诊断中可能是首选。