Systemic immune inflammation index may be a new powerful marker for the accurate early prediction of complications in patients with acute appendicitis

Year 2023, Volume: 48 Issue: 2, 679 - 685, 02.07.2023

Hüseyin Mutlu , Ekrem Taha Sert , Kamil Kokulu , Yakup Uslu

https://doi.org/10.17826/cumj.1276128

Abstract

Purpose: To investigate the relationship between the systemic immune-inflammatory index (SII) and acute appendicitis (AA).
Materials and Methods: We retrospectively evaluated patients aged over 18 years who were diagnosed with AA and underwent surgery at our clinic from January 1, 2019, through July 31, 2022. The patients were divided into three groups: complicated acute appendicitis (CAA), uncomplicated acute appendicitis (UAA), and control. The clinical and laboratory characteristics of the patients evaluated at the emergency department were recorded. The neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR), and SII (neutrophil count x platelet count/lymphocyte count) were calculated.
Results: The study included a total of 1,456 patients, of whom 628 had UAA, 104 had CAA, and 714 were controls. The NLR, PLR, and SII values were statistically significantly higher in the CAA group than in the control group and the UAA group. The multivariate logistic regression analysis revealed that SII was an independent predictor of CAA development (odds ratio [OR]: 4.65; 95% confidence interval [CI]: 2.31–10.17). The predictive power of SII in the prediction of CAA (area under the curve [AUC]: 0.809) was much higher than that of NLR (AUC: 0.729), neutrophil count (AUC: 0.696), and C-reactive protein (AUC: 0.732) alone. It was determined that an SII value greater than 1,989.2 had a sensitivity of 78.4% and a specificity of 88.5% in predicting CAA development.
Conclusion: SII is a simple, inexpensive, and promising marker that could predict both the diagnosis and severity of appendicitis.

Keywords

systemic immune-inflammatory index, acute appendicitis, emergency department

Sistemik immün inflamasyon indeksi, akut apandisitli hastalarında komlikasyonun doğru erken tahmini için yeni ve güçlü bir belirteç olabilir

Abstract

Amaç: Bu çalışmada, sistemik immün-inflamatuar indeks (SII) ile Akut Apandisit (AA) arasındaki ilişkiyi araştırmayı amaçladık.
Gereç ve Yöntem: 1 Ocak 2019-31 Temmuz 2022 tarihleri arasında kliniğimizde AA tanısı konup ameliyat edilen, 18 yaş üstü hastaları retrospektif olarak analiz ettik. Hastalar; Complicated Akut apandisit (CAA), Uncomplicated Akut Apandisit (UAA) ve kontrol grubu olarak üçe ayrıldı. Hastaların Acil servisteki klinik ve laboratuvar özellikleri değerlendirildi. Hastaların nötrofil/lenfosit oranı (NLR) ve trombosit/lenfosit oranı (PLR) ve SII (nötrofil sayısı x trombosit sayısı /lenfosit sayısı) hesaplandı.
Bulgular: Çalışmaya 628 UAA, 104 CAA hastası ve 714 kontrol grubu olmak üzere toplam 1456 hasta dahil edildi. NLR, PLR ve SII değerleri CAA grubunda, UAA grubundan kontrol grubundan istatistiksel olarak anlamlı derecede yüksek bulundu. Multivariate lojistik regresyon analizi; SII’nın (odds ratio [OR]: 4.65; 95% confidence interval [CI]: 2.31–10.17). CAA gelişimi için bağımsız prediktör olduğunu gösterdi. SII (AUC: 0.809)’in CAA’yı tahmin etme gücünü, tek başına NLR (AUC: 0.729), Neutrophil (AUC: 0.696) ve CRP ‘den (AUC: 0.732) çok daha yüksek olarak tespit ettik.1989.2’den daha yüksek SII değerleri CAA gelişimini %78,4 duyarlılık ve %88,5 özgüllük ile öngördü
Sonuç: Bulgularımız, SII'nin apandisit tanısını ve ciddiyetini öngörebilen basit, ucuz, kolay ve umut verici bir belirteç olduğunu gösterdi.

Keywords

Sistemik immün-inflamatuar indeks, akut apandisit, acil servis

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