The predictors of complicated acute appendicitis: large unstained cells, gamma-glutamyl transferase, monocyte to platelet ratio, age and gender

Abstract

Aim: In this study, we sought to investigate possible biomarkers markers that can preoperatively distinguish complicated and non-complicated acute appendicitis. Material and Method: Patients who underwent appendectomy between February and December 2019 were screened retrospectively. Patients with pathology findings other than appendicitis were excluded. Patients with a confirmed diagnosis of acute appendicitis were categorized as complicated and non-complicated appendicitis for analysis of sociodemographic characteristics, comorbidities and preoperative laboratory parameters. Results: A total of 575 patients were included in the study. Among these, 432 (75.1%) were diagnosed with non-complicated appendicitis and 143 (24.9%) were diagnosed with complicated appendicitis. The mean (SD) age was 34.2±14.2 years. Hypertension, diabetes mellitus and hypothyroidism were the most frequent comorbidities. Age (OR, 1.026; p=0.010), male gender (OR, 1.837; p=0.044), LUC (OR: 19.868; p=0.034) and GGT (OR: 1.013; p=0.013) were associated with a higher risk of complicated appendicitis. An increase in monocyte to platelet ratio (MPR) (OR: 0.920; p=0.047) was associated with a lower risk of complicated appendicitis. Conclusion: In patients with acute appendicitis, parameters including age, gender, as well as LUC, GGT and MPR, which are easily available and relatively cheap biomarkers, can be useful to distinguish non-complicated and complicated cases preoperatively.

Keywords

• acute appendicitis
• appendectomy
• large unstained cells

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