Nötrofil/Lenfosit oranı, C- reaktif protein ve Alvarado Skorunun Akut Apandisit Düşünülen Hastalardaki Tanısal Değeri

Öz

Amaç: Akut apandisit’in acil servislere tanısı her zaman kolayca konulamamaktadır. Bu çalışmanın amacı acil servise karın ağrısı şikayeti ile başvuran hastalarda Nötrofil/ Lenfosit Oranı (NLO), CRP ve Alvarado skorunun akut apandisit tanısı koymadaki etkinliğini incelemektir. Yöntem: Bu prospektif çalışma, 6 aylık süreç boyunca ardışık hastalar üzerinde toplanmıştır. Çalışmaya karın ağrısı şikayeti ile acil servise başvuran, daha önce apendektomi geçirmemiş, hastalar dahil edilmiştir. Çalışmaya dahil edilen 296 hasta son tanı yönüyle incelenerek 6 gruba ayrıldı. Çalışmadan elde edilen veriler ışığında bu gruplar arasında CRP, sola kayma ve NLO gibi parametreler ile Alvarado skorunun karşılaştırılması yapıldı. Bulgular: Çalışmamızda elde edilen bulgular şu şekildedir: (A) Analizler sonucunda akut apandisit düşünülen grupta akut apandisit düşünülmeyen gruba göre daha yüksek NLO, yaymada sola kayma görülme oranı ve Alvorado skoru belirlenmiştir; (B) Akut apandisit histopatolojik olarak pozitif olan grupta negatif olan gruba göre sola kayma görülme oranı ve alvorado skoru anlamlı şekilde yüksek bulunmuştur. (C) akut apandisit histopatolojik incelenmesine göre, erken apandisit tanılı olgularda CRP değeri anlamlı şekilde düşükken, komplike olmuş apandisit olgularında anlamlı şekilde yüksektir. Sonuç: Akut apandisit olgularını ön görmede NLO, CRP ve Alvarado skoru faydalıdır. Ancak bu parametrelerinin tek başına kullanılmaları akut apandisit tanısını koymada kısıtlı beceriye sahiptir.

Anahtar Kelimeler

• Alvarado
• apandisit
• Nötrofil/ Lenfosit Oranı
• C-reaktif protein

Diagnostic Value of Neutrophil/lymphocyte ratio, C-reactive Protein and Alvarado Score in Patients With Acute Appendicitis

Abstract

Objective: Acute appendicitis is not always easily diagnosed in emergency departments. The aim of this study was to investigate the effectiveness of Neutrophil/Lymphocyte Ratio (NLR), CRP and Alvarado score in diagnosing acute appendicitis in patients presenting to the emergency department with abdominal pain. Method: This prospective study was collected on consecutive patients over a 6-month period. Patients who presented to the emergency department with abdominal pain and had not undergone appendectomy before were included in the study. The 296 patients included in the study were analyzed according to the last diagnosis and divided into 6 groups. In the light of the data obtained from the study, parameters such as CRP, left shift, NLO and Alvarado score were compared between these groups. Results: The findings obtained in our study are as follows: (A) As a result of the analyses, the NLO, the rate of left shift in the smear and the Alvorado score were higher in the group with acute appendicitis compared to the group without acute appendicitis; (B) The rate of left shift and the Alvorado score were significantly higher in the group with histopathologically positive acute appendicitis compared to the negative group. (C) According to histopathologic examination of acute appendicitis, CRP value was significantly lower in cases diagnosed with early appendicitis, while it was significantly higher in cases of complicated appendicitis. Conclusion: NLO, CRP and Alvarado score are useful in predicting acute appendicitis cases. However, the use of these parameters alone has limited ability to diagnose acute appendicitis.

Keywords

• Alvarado
• appendicitis
• Neutrophil/Lymphocyte Ratio
• C-reactive protein

Kaynakça

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