Tam Kan Sayımı Parametrelerinin Akut Apandisit Tanısındaki Değerinin Araştırılması

Year 2022, Volume: 5 Issue: 3, 199 - 206, 30.12.2022

Ömer Başer Taner Şahin Mustafa Karaağaç

https://doi.org/10.56150/tjhsl.1186365

Abstract

Giriş ve Amaç: Karın ağrısı, acil servise en sık başvuru nedenlerinden biridir. Acil cerrahi gerektiren bu hastalarda en sık saptanan patoloji akut apandisittir. Apandisit tanısı klinik değerlendirme, laboratuvar testleri ve radyolojik görüntüleme temelinde konur. Bu çalışmanın amacı acil servise karın ağrısı ile başvuran hastalarda rutin olarak araştırılan tam kan sayımı parametrelerinin akut apandisit tanısındaki değerini araştırmaktır.
Materyal ve Metot: Bu çalışma, 1 Ocak-31 Aralık 2019 tarihleri arasında Türkiye'de Kayseri Şehir Eğitim ve Araştırma Hastanesi Acil Tıp Kliniğinde akut apandisit tanısı almış olan 18 yaş üstü hastalar ve sağlık taraması için rutin kan tetkikleri yapılan, aktif şikayeti olmayan kontrol grubu kişiler ile retrospektif kohort bir çalışma şeklinde yapıldı. Grupların acil servise ve hastaneye başvuru anındaki demografik özelliklerinden oluşan veriler ve tam kan testlerinden elde edilen parametreler analiz edildi.
Bulgular: Akut apandisit hastalarının 388'i (%64,7) ve kontrol grubunun 380'i (%63,3) erkekti (p=0.674). Lökosit, nötrofil, çekirdekli kırmızı kan hücresi, nötrofil-lenfosit oranı ve trombosit-lenfosit oranı değerleri akut apandisit grubunda kontrol grubuna göre anlamlı derecede yüksekti (p<0,001).
Sonuç: Hiçbir laboratuvar testi akut apandisit tanısı için tek başına yeterli değildir. Ancak lökosit, nötrofil, çekirdekli kırmızı kan hücresi, nötrofil lenfosit oranı, trombosit lenfosit oranı değerlerinde yükselme ile lenfosit, RDW ve MPV değerlerinde düşme akut apandisit tanısında faydalı olabilir.

Keywords

Akut apandisit, acil tıp, tam kan sayımı, teşhis

Supporting Institution

Bulunmamaktadır.

An Investigation of the Usability of Complete Blood Count Parameters in the Diagnosis of Acute Appendicitis

Abstract

Introduction and Objective: Acute appendicitis is one of the most commonly diagnosed diseases in emergency departments, and it is the abdominal pathology that most frequently requires surgery. The purpose of this study was to investigate the value in the diagnosis of acute appendicitis of routinely investigated complete blood count parameters in patients presenting to the emergency department with abdominal pain.
Material and method: This study was planned as a retrospective cohort among patients over 18 years who were diagnosed with acute appendicitis in the tertiary emergency department in Türkiye between January 1 and December 31, 2019. Healthy volunteers aged over 18 with no active complaints undergoing routine blood tests for health screening were included in the control group. Both groups’ records were retrieved retrospectively from the hospital database. Data consisting of the groups’ demographic characteristics at the time of presentation to the emergency department and parameters obtained from complete blood tests were analyzed.
Results: A total of 1200 people were included in the study, 600 of which were in the control group. Men constituted 388 (64.7%) of the acute appendicitis patients and 380 (63.3%) of the control group(p=0.674). Leukocyte, neutrophil, nucleated red blood cell, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio values were significantly higher in the acute appendicitis group compared to the control group(p<0.001).
Conclusion: An increase in leukocyte, neutrophil, nucleated red blood cell values, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio and a decrease in lymphocyte, red blood cell distribution width and mean platelet volume values in the complete blood count of patients with acute appendicitis is a useful guide for diagnosis.

Keywords

Acute appendicitis, complete blood count, diagnosis, emergency medicine

References

• Shahid, M. H., Khan, F. I., Askri, Z. A., Asad, A., Saeed, R., Talib, T. B., Khan, A. Z., Fatima, T., & Afzal, M. F. (2022). Two-Year Experiences of 500 Appendectomies in Lahore General Hospital, Lahore. Cureus, 14(1), e21303. https://doi.org/10.7759/cureus.21303
• Moris, D., Paulson, E. K., & Pappas, T. N. (2021). Diagnosis and Management of Acute Appendicitis in Adults: A Review. JAMA, 326(22), 2299–2311. https://doi.org/10.1001/jama.2021.20502
• Brunicardi F, Andersen D, Billiar T, et al(2014). Schwartz'sPrinciples of Surgery, 10th ed. New York;McGraw-Hill. p.1241-1262.
• Tintinalli J(2016). Tintinalli’s Emergency Medicine A Comprehensive Study Guide, 8th ed. McGraw-Hill Education.p.532-535.
• Snyder, M. J., Guthrie, M., & Cagle, S. (2018). Acute Appendicitis: Efficient Diagnosis and Management. American family physician, 98(1), 25–33. [Cited: Aug 20, 2021]. Available from: https://www.aafp.org/pubs/afp/issues/2018/0701/p25.html
• Haghi, A. R., Pourmohammad, P., & Rabiee, M. (2019). Accuracy of Mean Platelet Volume (MPV) and Red Cell Distribution Width (RDW) for the Diagnosis of Acute Appendicitis: Evaluation of Possible New Biomarkers. Advanced journal of emergency medicine, 4(2), e20. https://doi.org/10.22114/ajem.v0i0.194
• Sevinç, M. M., Kınacı, E., Çakar, E., Bayrak, S., Özakay, A., Aren, A., & Sarı, S. (2016). Diagnostic value of basic laboratory parameters for simple and perforated acute appendicitis: an analysis of 3392 cases. Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 22(2), 155–162. https://doi.org/10.5505/tjtes.2016.54388
• Ugurlu, C., Yildirim, M., Ozturk, A. et al. Lymphocyte-to-C-reactive Protein Ratio: a New Biomarker to Predict Perforation in Acute Appendicitis. Indian J Surg 83, 980–986 (2021). https://doi.org/10.1007/s12262-021-02937-5
• Almström, M., Svensson, J. F., Svenningsson, A., Hagel, E., & Wester, T. (2018). Population-based cohort study on the epidemiology of acute appendicitis in children in Sweden in 1987-2013. BJS open, 2(3), 142–150. https://doi.org/10.1002/bjs5.52
• Acar, E., Özcan, Ö., Deliktaş, H., Beydilli, H., Kırlı, İ., Alataş, Ö. D., Şahin, C., Yıldırım, B., & Belli, A. K. (2016). Laboratory markers has many valuable parameters in the discrimination between acute appendicitis and renal colic. Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 22(1), 17–22. https://doi.org/10.5505/tjtes.2015.69488
• Boshnak, N., Boshnaq, M., & Elgohary, H. (2018). Evaluation of Platelet Indices and Red Cell Distribution Width as New Biomarkers for the Diagnosis of Acute Appendicitis. Journal of investigative surgery : the official journal of the Academy of Surgical Research, 31(2), 121–129. https://doi.org/10.1080/08941939.2017.1284964
• Daldal, E., & Dagmura, H. (2020). The Correlation between Complete Blood Count Parameters and Appendix Diameter for the Diagnosis of Acute Appendicitis. Healthcare (Basel, Switzerland), 8(1), 39. https://doi.org/10.3390/healthcare8010039
• Akyüz, M., Topal, U., Gök, M., Öz, B., İsaoğulları, Ş. Y., & Sözüer, E. M. (2020). Predictive Value of Neutrophil/Lymphocyte Ratios in the Diagnosis of Acute Appendicitis. Medical journal of bakirkoy, 16(1). https://doi.org/10.5222/BMJ.2020.18480
• Maghsoudi, L. H., Kabir, K., Soltanian, A., Pak, H., Ahmadinejad, M., & Ahmadi, A. K. (2021). A cross-sectional study on evaluation of complete blood count-associated parameters for the diagnosis of acute appendicitis. Health science reports, 4(3), e326. https://doi.org/10.1002/hsr2.326
• Pehlivanlı, F., & Aydin, O. (2019). Role of Platelet to Lymphocyte Ratio as a Biomedical Marker for the Pre-Operative Diagnosis of Acute Appendicitis. Surgical infections, 20(8), 631–636. https://doi.org/10.1089/sur.2019.042
• Hwang, S. Y., Shin, T. G., Jo, I. J., Jeon, K., Suh, G. Y., Lee, T. R., Yoon, H., Cha, W. C., & Sim, M. S. (2017). Neutrophil-to-lymphocyte ratio as a prognostic marker in critically-ill septic patients. The American journal of emergency medicine, 35(2), 234–239. https://doi.org/10.1016/j.ajem.2016.10.055
• Rajalingam, V. R., Mustafa, A., Ayeni, A., Mahmood, F., Shammout, S., Singhal, S., & Akingboye, A. (2022). The Role of Neutrophil-Lymphocyte-Ratio (NLR) and Platelet-Lymphocyte-Ratio (PLR) as a Biomarker for Distinguishing Between Complicated and Uncomplicated Appendicitis. Cureus, 14(1), e21446. https://doi.org/10.7759/cureus.21446
• Peksöz, R., & Bayar, B. (2021). The role of complete blood count parameters in diagnosing acute appendicitis and measuring the severity of inflammation. Akut apandisit tanısını koymada ve ciddiyetini belirlemede hemogram parametre değerlerinin rolü. Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 27(6), 654–661. https://doi.org/10.14744/tjtes.2020.69195
• Balta, S., & Ozturk, C. (2015). The platelet-lymphocyte ratio: A simple, inexpensive and rapid prognostic marker for cardiovascular events. Platelets, 26(7), 680–681. https://doi.org/10.3109/09537104.2014.979340
• Korniluk, A., Koper-Lenkiewicz, O. M., Kamińska, J., Kemona, H., & Dymicka-Piekarska, V. (2019). Mean platelet volume (MPV): new perspectives for an old marker in the course and prognosis of inflammatory conditions. Mediators of inflammation, 2019;2019:9213074. https://doi.org/10.1155/2019/9213074
• Monteiro Júnior, J., de Oliveira Cipriano Torres, D., & Filho, D. (2019). Hematological Parameters as Prognostic Biomarkers in Patients with Cardiovascular Diseases. Current cardiology reviews, 15(4), 274–282. https://doi.org/10.2174/1573403X15666190225123544
• Narcı, H., Oktay, M. M., Ayrık, C., & Çimen, M. (2021). Nucleated red blood cells as predictor of all-cause mortality in emergency department. The American journal of emergency medicine, 46, 335–338. https://doi.org/10.1016/j.ajem.2020.10.002