The Diagnostic Value of Systemic Inflammatory Markers in Acute Appendicitis

Document Type : Original Article

Authors

1 Innovative Medical Research Center, MMS.C., Islamic Azad University, Mashhad, Iran

2 Surgical Oncology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Department of Community Medicine, MMS.C., Islamic Azad University, Mashhad, Iran

4 Department of Emergency Medicine, Razavi Hospital, Mashhad, Iran

5 Department of General Surgery, MMS.C., Islamic Azad University, Mashhad, Iran

Abstract

Background: Early diagnosis of Acute Appendicitis (AA)can be challenging because it relies on the patient's signs and symptoms, which often mimic other abdominal pathologies.

Objectives: The study aimed to assess the importance of systemic inflammatory response parameters in contrast with the Alvarado scoring system.
 
Methods: This cross-sectional study was conducted on 300 patients diagnosed with AA who underwent an appendectomy. Demographic data, medical history, physical examination findings, Alvarado score, complete blood count (CBC), and pathology results of the appendix were documented.
 
Results: In a study involving 300 patients, 53.7% were male. The mean age of the patients was 37.24 ± 14.79 years. The number of females with a negative appendectomy was 2.45 times higher than that of males. Most patients with appendicitis were male, while most with RLH (reactive lymphoid hyperplasia) and normal appendices were female. For diagnosing AA, the following thresholds were established: NLR (neutrophil-to-lymphocyte ratio) >2.93 with 90.08% sensitivity and 76.32% specificity, PLR (platelet-to-lymphocyte ratio) >117.8 with 70.61% sensitivity and 65.79% specificity. The sensitivity of the Alvarado scoring system was 79.8%, and its specificity was 81.6% at >6 cut-off value.
 
Conclusion: NLR, PLR, CRP (C-reactive protein), SII (systemic immune inflammation index), and Alvarado scoring showed great potential in diagnosing appendicitis with acceptable sensitivity and specificity.

Keywords

Acknowledgements: The authors would like to thank all participants in this study. We also appreciate the support of Mashhad University of Medical Sciences for conducting this research.

 

Availability of data and materials: All data generated or analysed during this study are included in this published article.

 

Conflicts of interests: All authors declared that they have no competing interests.

 

Consent for publication: Not Applicable

 

Ethics approval and consent to participate: The present study has a code of ethics with an ID number (IR.MUMS.REC.1401.105).The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki.

 

Financial disclosure: No financial support was received for this study.

 

Author contributions: Conceptualization: TZ and MRT - Methodology and Formal analysis: YR and MM- Investigation, Data curation: MRT, TZ, YA and, AD - Writing- Original draft: MRT- Writing - review & editing: TZ.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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