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Door-to-surgery time and systemic immune-inflammatory indices in acute appendicitis: diagnostic performance and clinical associations

Cilt: 36 Sayı: 2026 27 Ekim 2026
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Door-to-surgery time and systemic immune-inflammatory indices in acute appendicitis: diagnostic performance and clinical associations

Öz

Aim: In acute appendicitis (AA), early differentiation between complicated AA (CA) and uncomplicated AA (UCA) directly affects the treatment process. This study investigated the diagnostic performance of the Systemic Immune-Inflammation Index (SII) and the Systemic Inflammatory Response Index (SIRI) in distinguishing CA from UCA, as well as the association between door-to-surgery time (DST) and clinical outcomes.
Materials and Methods: Patients who presented to the emergency department and underwent surgery with a diagnosis of AA between January 1, 2020, and December 31, 2024, were retrospectively evaluated. According to the pathology reports, cases of perforated or gangrenous appendicitis were classified as CA, whereas cases of simple or suppurative/phlegmonous AA were classified as UCA. DST, defined as the time (minutes) from the patient’s admission to the emergency department until the start of surgery, was calculated for each patient.
Results: After applying exclusion criteria, 556 patients were included in the analysis. Of the patients, 16.9% (n=94) were classified as CA, and 83.1% (n=462) as UCA. In the CA group, median age, monocyte count, C-reactive protein (CRP), SII, and SIRI were significantly higher, whereas lymphocyte count was significantly lower. In ROC analysis, CRP showed the highest diagnostic performance (AUC: 0.741; threshold: 39.1 mg/L; sensitivity: 61.7%; specificity: 79.3%). SII (AUC: 0.597) and SIRI (AUC: 0.612) yielded statistically significant AUC values but showed limited discriminative ability. No significant association was found between DST and CA, whereas a weak positive correlation was found between CRP and length of hospital stay (r=0.285; p<0.001).
Conclusions: SII and SIRI were significantly elevated in CA, but their diagnostic performance was lower than that of CRP. The findings suggest that moderate in-hospital delay was not associated with increased rates of CA in this cohort. Prospective studies evaluating the combined use of these indices with CRP and their integration into clinical scoring systems are needed.

Anahtar Kelimeler

Complicated acute appendicitis, door-to-surgery time, length of hospital stay, systemic inflammatory response index, systemic immune-inflammatory index

Destekleyen Kurum

None

Etik Beyan

All procedures were conducted in accordance with the principles of the Declaration of Helsinki.

Teşekkür

None

Kaynakça

  1. 1. Krzyzak M, Mulrooney SM. Acute Appendicitis Review: Background, Epidemiology, Diagnosis, and Treatment. Cureus. 2020; 12(6): e8562.
  2. 2. Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet. 2015; 386(10000): 1278-1287.
  3. 3. Ferris M, Quan S, Kaplan BS, Molodecky N, Ball CG, Chernoff GW, et al. The Global Incidence of Appendicitis: A Systematic Review of Population-based Studies. Ann Surg. 2017; 266(2): 237-241.
  4. 4. Duyan M, Vural N. Assessment of the Diagnostic Value of Novel Biomarkers in Adult Patients With Acute Appendicitis: A Cross-Sectional Study. Cureus. 2022; 14(12): e32307.
  5. 5. Berhuni MS, Yönder H, Elkan H, Koyuncu MH, Özgül F, Tatlı F, et al. Diagnostic Value of Systemic Immune Inflammation Index in Identifying Complicated Acute Appendicitis Cases. Cureus. 2024; 16(11): e73046.
  6. 6. Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014; 20(23): 6212-6222.
  7. 7. Liang L, Su Q. Systemic immune-inflammation index and the short-term mortality of patients with sepsis: A meta-analysis. Biomol Biomed. 2025; 25(4): 798-809.
  8. 8. Menyhart O, Fekete JT, Győrffy B. Inflammation and Colorectal Cancer: A Meta-Analysis of the Prognostic Significance of the Systemic Immune-Inflammation Index (SII) and the Systemic Inflammation Response Index (SIRI). Int J Mol Sci. 2024; 25(15): 8441.
  9. 9. Siki FÖ, Sarıkaya M, Gunduz M, Sekmenli T, Korez MK, Ciftci I. Evaluation of the systemic immune inflammation index and the systemic inflammatory response index as new markers for the diagnosis of acute appendicitis in children. Ann Saudi Med. 2023; 43(5): 329-338.
  10. 10. van Dijk ST, van Dijk AH, Dijkgraaf MG, Boermeester MA. Meta-analysis of in-hospital delay before surgery as a risk factor for complications in patients with acute appendicitis. Br J Surg. 2018; 105(8): 933-945.

Kaynak Göster

APA
Değirmenci, S., Arıkan, E., Zeytin, A. T., Boz, M., Erismis, M., & Dokur, M. (2026). Door-to-surgery time and systemic immune-inflammatory indices in acute appendicitis: diagnostic performance and clinical associations. Genel Tıp Dergisi, 36(2026), 1-6. https://doi.org/10.54005/geneltip.1948073
AMA
1.Değirmenci S, Arıkan E, Zeytin AT, Boz M, Erismis M, Dokur M. Door-to-surgery time and systemic immune-inflammatory indices in acute appendicitis: diagnostic performance and clinical associations. Genel Tıp Derg. 2026;36(2026):1-6. doi:10.54005/geneltip.1948073
Chicago
Değirmenci, Selim, Erhan Arıkan, Ahmet Tuğrul Zeytin, Mustafa Boz, Mustafa Erismis, ve Mehmet Dokur. 2026. “Door-to-surgery time and systemic immune-inflammatory indices in acute appendicitis: diagnostic performance and clinical associations”. Genel Tıp Dergisi 36 (2026): 1-6. https://doi.org/10.54005/geneltip.1948073.
EndNote
Değirmenci S, Arıkan E, Zeytin AT, Boz M, Erismis M, Dokur M (01 Ekim 2026) Door-to-surgery time and systemic immune-inflammatory indices in acute appendicitis: diagnostic performance and clinical associations. Genel Tıp Dergisi 36 2026 1–6.
IEEE
[1]S. Değirmenci, E. Arıkan, A. T. Zeytin, M. Boz, M. Erismis, ve M. Dokur, “Door-to-surgery time and systemic immune-inflammatory indices in acute appendicitis: diagnostic performance and clinical associations”, Genel Tıp Derg, c. 36, sy 2026, ss. 1–6, Eki. 2026, doi: 10.54005/geneltip.1948073.
ISNAD
Değirmenci, Selim - Arıkan, Erhan - Zeytin, Ahmet Tuğrul - Boz, Mustafa - Erismis, Mustafa - Dokur, Mehmet. “Door-to-surgery time and systemic immune-inflammatory indices in acute appendicitis: diagnostic performance and clinical associations”. Genel Tıp Dergisi 36/2026 (01 Ekim 2026): 1-6. https://doi.org/10.54005/geneltip.1948073.
JAMA
1.Değirmenci S, Arıkan E, Zeytin AT, Boz M, Erismis M, Dokur M. Door-to-surgery time and systemic immune-inflammatory indices in acute appendicitis: diagnostic performance and clinical associations. Genel Tıp Derg. 2026;36:1–6.
MLA
Değirmenci, Selim, vd. “Door-to-surgery time and systemic immune-inflammatory indices in acute appendicitis: diagnostic performance and clinical associations”. Genel Tıp Dergisi, c. 36, sy 2026, Ekim 2026, ss. 1-6, doi:10.54005/geneltip.1948073.
Vancouver
1.Selim Değirmenci, Erhan Arıkan, Ahmet Tuğrul Zeytin, Mustafa Boz, Mustafa Erismis, Mehmet Dokur. Door-to-surgery time and systemic immune-inflammatory indices in acute appendicitis: diagnostic performance and clinical associations. Genel Tıp Derg. 01 Ekim 2026;36(2026):1-6. doi:10.54005/geneltip.1948073