Loading [a11y]/accessibility-menu.js
Research Article
BibTex RIS Cite

Akut ve Komplike Apandisit Ayırıcı Tanısında Laboratuvar Parametrelerinin Önemi

Year 2022, Volume: 19 Issue: 3, 617 - 620, 27.12.2022
https://doi.org/10.35440/hutfd.1185813

Abstract

Apandisit ayırıcı tanısında kan değerlerinin etkinliği
Amaç: Bu çalışmada albumin/C-reaktif protein (Crp), lökosit/nötrofil ve platelet/lökosit değerlerinin preoperatif akut ve komplike apandisit ayırıcı tanısındaki yararının değerlendirilmesi amaçlandı.
Materyal ve metod: Mart 2019-2021 dönemleri arasında appendektomi olan 18 yaş altındaki 380 hastanın demografik verileri, preoperatif kan parametreleri ve histopatolojik değerlendirme sonuçları geriye dönük olarak incelendi. Hastalar histopatolojik değerlendirme sonuçlarına göre akut, komplike ve negatif apandisit olarak 3 gruba ayrıldı. Negatif appendektomi olan hasta grubu kontrol grubu olarak kabul edildi. Grupların lökosit/nötrofil, albumin/crp, platelet/lökosit oranları birbiriyle karşılaştırıldı.
Bulgular: Komplike apandisit olanların hastane yatış ortalaması akut ve kontrol grubuna göre daha yüksek iken akut apandisit olanların ortalaması kontrol grubuna göre daha yüksektir.Lökosit, nötrofil değerleri, gruplara göre anlamlı farklılık göstermektedir (p<0,05). Sonuçlar incelendiğinde akut ve komplike apandisitlerin ortalaması kontrol grubuna göre daha yüksektir.Hemoglobin ve hematokrit değerleri gruplara göre anlamlı farklılık göstermektedir (p<0,05). Akut apandisit ve kontrol grubunda olanların ortalaması komplike apandisit olanlara göre daha yüksektir. Albumin ve albumin/crp oranı, gruplara göre anlamlı farklılık göstermektedir (p<0,05). Akut apandisit ve kontrol grubunda olanların ortalaması komplike apandisit olanlara göre daha yüksektir.Crp, gruplara göre anlamlı farklılık göstermektedir (p<0,05). Komplike apandisit olanların ortalaması akut apandisit ve kontrol grubunda olanlara göre daha yüksektir.Platelet/lökosit oranı, gruplara göre anlamlı farklılık göstermektedir (p<0,05). Kontrol grubunda olanların ortalaması akut ve komplike apandisit olanlara göre daha yüksektir.
Sonuç: Karın ağrısı ile başvuran bir hastanın anamnez ve fizik muayene bulgularına ek olarak kan parametrelerinden yararlanarak preoperatif akut ya da komplike apandisit ayırıcı tanısı koyabilmek cerrahın tedavi şekline karar vermesini kolaylaştıracaktır. Çalışmada lökosit/nötrofil oranı, anlamlı sonuç vermemişken albumin/crp oranı preoperatif akut ve komplike apandisit ayırıcı tanısında yardımcı olabilir. Bununla birlikte daha geniş hasta popülasyonları ve ek enfeksiyon belirteçleri ile yapılacak çalışmalara ihtiyaç duyulduğu aşikardır.

Supporting Institution

yOK

Project Number

YOK

Thanks

YOK

References

  • 1. Rentea RM, Peter SD. Pediatric appendicitis. Surgical Clinics, 2017, 97(1): 93-112.
  • 2. Begic-Kapetanovic S, Avdagic N, Zaciragic A, Hasic S, Babic N, Hadzimuratovic A. Could the neutrophil-to-lymphocyte ratio serve as a marker in the diagnosis and prediction of acute appendicitis complications in children?. Archives of Medical Science, 2021,17(6):1672.
  • 3. Xu T, Zhang Q, Zhao H, Meng Y, Wang F, Li Y, Zhang P. A risk score system for predicting complicated appendicitis and aid decision-making for antibiotic therapy in acute appendicitis. Annals of palliative medicine, 2021, 10(6): 6133-44.
  • 4. Nissen M, Tröbs R. The lymphocyte-to-monocyte ratio may distinguish complicated from non-complicated pediatric appendicitis: A retrospective study and literature review. Pediatrics &Neonatology, 2021, 8: 18.
  • 5. Liu L, Shao Z, Yu H, Zhang W, Wang H, Mei Z. Is the platelet to lymphocyte ratio a promising biomarker to distinguish acute appendicitis? Evidence from a systematic review with meta-analysis. PloS one, 2020, 15(5): e0233470.
  • 6. Hakkoymaz H, Nazik S, Seyithanoğlu M, Güler Ö, Şahin AR, Cengiz E, Yazar FM. The value of ischemia-modified albumin and oxidative stress markers in the diagnosis of acute appendicitis in adults. The American Journal of Emergency Medicine, 2019, 37(11): 2097-101.
  • 7. Shimizu T, Ishizuka M, Kubota K. A lower neutrophil to lymphocyte ratio is closely associated with catarrhal appendicitis versus severe appendicitis. Surgery Today, 2016, 46(1): 84-9.
  • 8. Dogan S, Dorter M, Kalafat UM, Bildik B, Yazıcı R, Sarıcı İŞ, Cander B. Diagnostic value of C-reactive protein/albumin ratio to differentiate simple versus complicated appendicitis. Eurasian Journal of Emergency Medicine, 2020, 19(3): 178.
  • 9. Hou J, Feng W, Liu W, Hou J, Die X, Sun J. The use of the ratio of C-reactive protein to albumin for the diagnosis of complicated appendicitis in children. The American Journal of Emergency Medicine, 2022, 52: 148-154.

The Importance of Laboratory Parameters in The Differential Diagnosis of Acute and Complicated Appendicitis

Year 2022, Volume: 19 Issue: 3, 617 - 620, 27.12.2022
https://doi.org/10.35440/hutfd.1185813

Abstract

Background: It was aimed to evaluate the benefit of albumin/C-reactive protein (Crp), leukocyte/neutrophil and platelet/leukocyte values in the differential diagnosis of acute and complicated appendicitis.
Materials and Methods: Demographic data, preoperative blood parameters and histopathological evaluation results of 380 patients who underwent appendectomy between March 2019-2021 were analyzed retrospecti-vely.
Results: The mean hospitalization of patients with complicated appendicitis is higher than the acute and control group, while the mean of those with acute appendicitis is higher than the control group. Leukocyte and neut-rophil values showed significant differences according to the groups (p<0.05). The mean of acute and complica-ted appendicitis was higher than the control group. Hemoglobin and hematocrit values showed significant diffe-rences (p<0.05). The mean of acute appendicitis and control group is higher than those with complicated ap-pendicitis. Albumin and albumin/crp ratio showed significant differences (p<0.05). The mean of acute appendici-tis and control group is higher than those with complicated appendicitis. Crp differed significantly according to the groups (p<0.05). The average rate of those with complicated appendicitis is higher than those in the acute appendicitis and control group. The platelet/leukocyte ratio differed significantly according to the groups (p<0.05). The mean rate of those in the control group is higher than those with acute and complicated appendi-citis.
Conclusions: In addition to the history and physical examination findings of a child presenting with abdominal pain, making the differential diagnosis of preoperative acute or complicated appendicitis by using blood parame-ters will make it easier for the surgeon to decide on the treatment method. In our study, while the leukocy-te/neutrophil ratio did not give significant results, it was seen that the albumin/crp ratio could be used in the differential diagnosis of acute and complicated appendicitis preoperatively. It is obvious that studies with large patient populations and additional markers of infection are needed.


Key Words: Pediatrics, appendicitis, infection markers

Project Number

YOK

References

  • 1. Rentea RM, Peter SD. Pediatric appendicitis. Surgical Clinics, 2017, 97(1): 93-112.
  • 2. Begic-Kapetanovic S, Avdagic N, Zaciragic A, Hasic S, Babic N, Hadzimuratovic A. Could the neutrophil-to-lymphocyte ratio serve as a marker in the diagnosis and prediction of acute appendicitis complications in children?. Archives of Medical Science, 2021,17(6):1672.
  • 3. Xu T, Zhang Q, Zhao H, Meng Y, Wang F, Li Y, Zhang P. A risk score system for predicting complicated appendicitis and aid decision-making for antibiotic therapy in acute appendicitis. Annals of palliative medicine, 2021, 10(6): 6133-44.
  • 4. Nissen M, Tröbs R. The lymphocyte-to-monocyte ratio may distinguish complicated from non-complicated pediatric appendicitis: A retrospective study and literature review. Pediatrics &Neonatology, 2021, 8: 18.
  • 5. Liu L, Shao Z, Yu H, Zhang W, Wang H, Mei Z. Is the platelet to lymphocyte ratio a promising biomarker to distinguish acute appendicitis? Evidence from a systematic review with meta-analysis. PloS one, 2020, 15(5): e0233470.
  • 6. Hakkoymaz H, Nazik S, Seyithanoğlu M, Güler Ö, Şahin AR, Cengiz E, Yazar FM. The value of ischemia-modified albumin and oxidative stress markers in the diagnosis of acute appendicitis in adults. The American Journal of Emergency Medicine, 2019, 37(11): 2097-101.
  • 7. Shimizu T, Ishizuka M, Kubota K. A lower neutrophil to lymphocyte ratio is closely associated with catarrhal appendicitis versus severe appendicitis. Surgery Today, 2016, 46(1): 84-9.
  • 8. Dogan S, Dorter M, Kalafat UM, Bildik B, Yazıcı R, Sarıcı İŞ, Cander B. Diagnostic value of C-reactive protein/albumin ratio to differentiate simple versus complicated appendicitis. Eurasian Journal of Emergency Medicine, 2020, 19(3): 178.
  • 9. Hou J, Feng W, Liu W, Hou J, Die X, Sun J. The use of the ratio of C-reactive protein to albumin for the diagnosis of complicated appendicitis in children. The American Journal of Emergency Medicine, 2022, 52: 148-154.
There are 9 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Article
Authors

Gonca Gerçel 0000-0003-1395-1764

Ali İhsan Anadolulu 0000-0002-9742-930X

Project Number YOK
Publication Date December 27, 2022
Submission Date October 7, 2022
Acceptance Date November 8, 2022
Published in Issue Year 2022 Volume: 19 Issue: 3

Cite

Vancouver Gerçel G, Anadolulu Aİ. Akut ve Komplike Apandisit Ayırıcı Tanısında Laboratuvar Parametrelerinin Önemi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2022;19(3):617-20.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty