Komplike Apandisitin Belirlenmesinde Temel Laboratuvar Parametrelerinin Tanısal Değeri

Year 2024, , 42 - 49, 30.06.2024

Mehmet Uluşahin , Ahmet Ünal , Serdar Türkyılmaz

https://doi.org/10.59518/farabimedj.1392105

Abstract

Bu çalışmanın amacı akut apandisit nedeni ile opere edilen hastalarda laboratuvar parametrelerinin komplike apandisit öngörülmesindeki etkinliğini araştırmaktır. Appendektomi uygulanmış ve patoloji sonucu akut apandisit olarak bildirilen 153 hasta çalışmaya dahil edildi. Hastalar patoloji sonuçları ve operasyon bulgularına göre basit ve komplike apandisit olarak iki gruba ayrıldı. Hastalara ait yaş, cinsiyet, operasyon öncesi lökosit sayısı, nötrofil sayısı, nötrofil yüzdesi, nötrofil-lenfosit oranı, eritrosit dağılım genişliği, ortalama trombosit hacmi ve C-reaktif protein değerleri kaydedildi. Basit apandisit grubunda 97, komplike apandisit grubunda 56 hasta mevcuttu. Her iki grupta da erkek cinsiyet ön planda idi. Komplike apandisit gubunda yaş daha ileri idi (p=0.007). Lökosit sayısı (p<0.001), nötrofil sayısı (p=0.007), nötrofil yüzdesi (p<0.001), nötrofil-lenfosit oranı (p<0.001) ve C-reaktif protein (p<0.001) komplike apandisit grubunda istatistiksel olarak anlamlı fark oluşturacak şekilde yüksek tespit edildi. Eritrosit dağılım genişliği ve ortalama trombosit hacmi için gruplar arasında anlamlı fark yoktu. Kesim değerleri yaş için 24.5/yıl, lökosit sayısı için 12500/µL, nötrofil sayısı için 9950/µL, nötrofil yüzdesi için % 78.15, nötrofil-lenfosit oranı için 4.98 ve C-reaktif protein için 0.29 mg/dl olarak hesaplandı. Lojistik regresyon analizinde yaş (OR:1.036) nötrofil sayısı (OR: 14.934) ve C-reaktif protein (OR: 4.225) komplike apandisit tanısı için bağımsız risk faktörleri olarak tespit edildi. Yaş, nötrofil sayısı ve C-reaktif protein basit-komplike apandisit ayrımında yardımcı parametreler olarak kullanılabilir.

Keywords

Akut apandisit, C-reaktif protein, Karın ağrısı, Komplike

Diagnostic Value of Basic Laboratory Parameters in the Diagnosis of Complicated Appendicitis

Abstract

In this investigation, we sought to examine the efficacy of laboratory parameters in predicting complicated appendicitis in patients who had surgery for acute appendicitis. 153 patients who underwent appendectomy were included and whose pathological results showed acute appendicitis. The patients were divided into two groups based on pathology findings and surgical findings: simple and complicated appendicitis groups. The patients’ age, gender, preoperative leukocyte count, neutrophil count, neutrophil percentage, neutrophil–lymphocyte ratio, erythrocyte distribution width, mean platelet volume, and C-reactive protein levels were recorded. The simple and complicated appendicitis groups comprised 97 and 56 patients, respectively. Patients with complicated appendicitis were older on average than those with simple appendicitis (p=0.007). In the complicated appendicitis group, leukocyte count (p<0.001), neutrophil count (p=0.007), neutrophil percentage (p<0.001), neutrophil–lymphocyte ratio (p<0.001), and C-reactive protein levels (p<0.001) were significantly higher than in the simple appendicitis group. In terms of erythrocyte distribution width and mean platelet volume, there were no statistically significant differences between the groups. The cut-off values for age, leukocyte count, neutrophil count, neutrophil percentage, neutrophil–lymphocyte ratio, and C-reactive protein levels were 24.5/years, 12.500/µL, 9.950/µL, 78.15%, 4.98, and 0.29 mg/dL, respectively. Logistic regression analysis showed that age (OR: 1.036), neutrophil count (OR: 14.934), and C-reactive protein levels (OR: 4.225) are independent risk factors for the diagnosis of complicated appendicitis. Thus, age, neutrophil count, and C-reactive protein levels may be used as auxiliary parameters to differentiate between simple and complicated appendicitis.

Keywords

Abdominal pain, Acute appendicitis, Complicated, C-reactive protein

Ethical Statement

None of the authors have potential conflicts of interest to be disclosed.

Supporting Institution

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Thanks

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