Çocuk Acilde Hemogramdan Hesaplanan Basit Laboratuvar Parametreleri, Komplike Akut Apandisitin Öngörülmesinde Kullanılabilir mi?

Öz

Bu çalışmada, sistemik immün-inflamasyon indeksi , C-reaktif protein , nötrofil-lenfosit oranı, plateletkrit ve trombosit-lenfosit oranının çocuklarda komplike akut apandisit tanısındaki önemini belirlemeyi amaçladık. Çalışmaya, çocuk acil servise başvuran ve akut apandisit tanısıyla cerrahi tedavi uygulanan hastalar dahil edildi. Ameliyat sonrası, hastalar histopatolojik ve radyolojik bulgulara göre iki gruba ayrıldı: Komplike olmayan apandisit ve komplike apandisit. Gruplar yaş, cinsiyet, sistemik immün-inflamasyon indeksi, nötrofil-lenfosit oranı, plateletkrit , trombosit-lenfosit oranı (PLR) ve C-reaktif protein düzeyleri açısından karşılaştırıldı. Toplamda 287 hasta çalışmaya alındı; 197’si komplike olmayan apandisit grubunda, 90’ı ise komplike apandisit grubunda yer aldı. Komplike apandisit grubunda CRP (p=0,001), NLR (p=0,001) ve PLR (p=0,01) düzeyleri anlamlı olarak daha yüksek bulundu. Cinsiyet, lökösit sayısı, nötrofil sayısı, SII ve PCT açısından gruplar arasında anlamlı bir fark saptanmadı. Ayrıca, komplike apandisit grubunda ortalama yaş ve bilgisayarlı tomografi çekilme oranının daha yüksek olduğu gözlendi. CRP, nötrofil/lenfosit oranı ve trombosit/lenfosit oranı, çocuklarda komplike ve komplike olmayan apandisiti ayırt etmede yardımcı olabilecek laboratuvar parametreleridir. Bu evrensel parametreler, zor tanı konulan hasta grubunda tedavi planlamasına ve cerrahi karar sürecine katkı sağlayabilir.

Anahtar Kelimeler

• Sistemik immün-inflamasyon indeksi
• akut apandisit
• pediatri
• CRP

Could Simple Laboratory Parameters Calculated from Blood Tests Be Predictive of Complicated Acute Appendicitis in The Pediatric Emergency Department?

Öz

We aimed to determine the importance of systemic immune-inflammation index (SII), CRP (C-Reactive Protein), neutrophil-lymphocyte ratio (NLR), plateletcrit (PCT), platelet-lymphocyte ratio (PLR) in the diagnosis of complicated acute appendicitis in children. The study included patients who presented to the pediatric emergency department and underwent surgery with a diagnosis of acute appendicitis. After surgery, patients were divided into two groups: uncomplicated appendicitis and complicated appendicitis based on histopathologic and radiologic findings. The groups were compared based on age, sex, systemic immune-inflammation index (SII), neutrophil-lymphocyte ratio (NLR), plateletcrit (PCT), platelet-lymphocyte ratio (PLR), and C-reactive protein (CRP). Total of 287 patients were included in our study. While 197 patients were in the uncomplicated acute appendicitis (UA) group, 90 patients were included in the complicated acute appendicitis (CA) group. When the two groups were compared, CRP (p=0.001), NLR (p=0.001) and PLR (p=0.01) were significantly higher in the CA group. No difference was found in gender, white blood cell count, neutrophil count, SII and PCT. Computed tomography was performed at a higher rate in the CA group. CRP, neutrophil/lymphocyte ratio, and platelet/lymphocyte ratio are open laboratory parameters that can assist in differentiating between complicated and uncomplicated appendicitis in children. These universal parameters may inform the treatment plan and decision to operate on a challenging-to-diagnose population.

Anahtar Kelimeler

• Systemic immune-inflammation index
• acute appendicitis
• pediatrics
• CRP

Kaynakça

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