C-reactive protein and red cell distribution width as indicators of complications in patients with acute appendicitis

Yıl 2019, Cilt: 4 Sayı: 2, 76 - 80, 01.08.2019

Okan Murat Aktürk , Mikail Çakır Doğan Yıldırım Muzaffer Akıncı

https://doi.org/10.25000/acem.546308

Cited By: 2

Öz

Aim: Acute appendicitis is one of the most common operations in general
surgery. When complicated, mortality and morbidity increases. We aimed to find
out whether use of C-reactive protein (CRP) and red cell distribution width
(RDW) may help to find out development of complications with acute  appendicitis at initial evaluation in an
emergency department.

Methods: Files of the patients who underwent operations for acute
appendicitis between January 2017 and August 2017 were reviewed. Development of
complications was recorded and the patients were grouped as with and without
complications and were compared about age, sex RDW, CRP, alanine
aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Diagnostic
efficiency of CRP and RDW on the development of complications in acute
appendicitis was investigated with regression analysis and by receiver operator
characteristic curve analysis.

Results: Age, CRP and RDW were found to be significantly related to
perforation (p<0.001 for all) (Bonferoni correction), while white blood cell
(WBC), AST and ALT were found to be insignificant (p=0.052, p=0.806 and
p=0.804, respectively. There was a significant correlation between
RDW and CRP in the Spearman non-parametric correlation analysis (correlation
coefficient r=0.244 and p<0.001). There was no significant correlation of WBC to CRP and RDW.

Conclusion:
CRP and RDW are biochemical parameters that help us to identify the development
of complications in acute appencitis. CRP may be elevated in acute
appendicitis; however, it must be kept in mind to be cautious about a
potentially complicated acute appendicitis after a certain level, RDW in our
study has been found to be elevated in complicated appendicitis cases; but,
it  may not helpful to detect for
perforated or gangrenous appendicitis.

Anahtar Kelimeler

acute appendicitis, hematologic tests, laboratory analysis, complications

Akut apandisit tanısı konmuş hastalarda komplikasyon belirteçleri olarak C-reaktif protein ve kırmızı küre dağılım indisinin yeri ve önemi

Öz

 Amaç: Akut apandisit genel cerrahide en sık
karşılaşılan operasyon sebeplerinden 
biridir.  Komplike olduğu zaman
mortalite ve morbidite artmaktadır. C-reaktif protein (CRP) ve kırmızı küre
genişlik dağılım indisi (RDW) değerlerinin kullanılması komplike olan akut
apandisit vakalarını acil servisteki ilk muayenede ayırt etmemizde faydalı olup
olmadığını incelemeyi amaçladık.

Yöntemler: Ocak  2017 ve Ağustos 2017 tarihleri arasında akut
apandisit nedeniyle opere edilmiş olan hastaların dosyaları tarandı. Hastalar
yaş, cinsiyet, CRP, RDW, alanin aminotrasferaz, aspartat aminotransferaz
değerleri açısından komplike olan ve olmayan akut apandisit vakalarında
karşılaştırıldı. Artmış serum CRP ve RDW değerlerinin komplike apandisit tanısı
koymada ne kadar etkin olduğu regresyon analizi ve alıcı işlemci karakteristiği
eğrisi analizi ile değerlendirildi.

Bulgular: Yaş, RDW ve CRP, perforasyon ve
gangrenöz apandisit ile belirgin olarak ilişkili olarak bulundu, p<0,001,
beyaz küre, aspartat aminotransferaz (AST), alanin aminotransferaz (ALT)
düzeyleri ise P değerleri açısından anlamsız olarak bulundu (sırasıyla p=0,052,
p=0,806 ve p=0,804). RDW ile CRP arasında korelasyon olmakla birlikte
(korelasyon katsayısı r=0,244 ve p<0,001), beyaz küre ile RDW ve CRP arasında
anlamlı bir ilişki yoktu.

Sonuç: CRP ve RDW komplike
apandisit tanısını koymamızda biyokimsasal parametre olarak
değerlendirilmelidir. CRP akut apandisit vakalarında artmış olarak tespit
edilebilir ancak belli bir seviyeden sonra komplike olmuş bir apandisite işaret
edebilir. RDW bizim çalışmamızda komplike apandisitlerde artmış olarak bulundu.
Ancak bu yükseklik için bir eşik değer tespit edilemedi.

Anahtar Kelimeler

akut apendisit, hematolojik testler, laboratuar analiz, komplikasyonlar

Kaynakça

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