Laboratory in complicated appendicitis prediction and predictive value of monitoring

Abstract

OBJECTIVES: The purpose of the study was that monitoring, which is used in diagnosis of acute appendicitis, and laboratory values, were evaluated for verifying diagnosis of complicated appendicitis and these parameters revealed cut-offvalues in complicated acute/non-complicated appendicitis. METHODS: 195 patients, who had had an operation for acute appendicitis between January 2012 and March 2015 and who were proved to have acute complicated/non-complicated appendicitis from the results of histopathology consideration, were included in this study. Patients' age, preoperative serum, WBC, CRP, NLR and BT with USG results were evaluated. RESULTS: Among the groups, there were no meaningful differences in the sense of age. Meaningful difference was obtained in between (p > 0.05), WBC, NLR, CRP and appendix diameter values. Serum in WBC > 13800 (AUC = 0.614, p = 0.006, %95 GA: 0.541-0.682), in NLR > 4.87 (AUC = 0.641, p = 0.001, %95 GA: 0.569-0.708), in CRP > 5.98 (AUC = 0.651, p < 0.000, %95 GA: 0.580-0.718), in the measurement > 11 mm (AUC = 0.630, p = 0.002, %95 GA: 0.558-0.698) values were obtained. The values that were obtained, were confirmed to be descriptive in analysis of complicated appendicitis and non-complicated appendicitis. According to the obtained cut-offvalues, serum WBC, diameter of appendicitis, NLR and CRP values', (OR) ratios were calculated for complicated appendicitis by being classified (odds ratio respectively; 3.103 (1.713- 5.621), 2.765 (1.496-5.109), 3.025 (1.665-5.494), 2.313 (1.295-4.130)). CONCLUSION: It is important that treatment options are evaluated to be able to discriminate complicated appendicitis fast and with a high accuracy. In the case that serum WBC is higher than 13800. CRP is higher than 5.98, NLR is higher than 4.87 and appendicitis diameter is longer than 11mm, inflammation of appendicitis is complex with gangrene, perforation and abscess and it emphasizes the suggestion of surgical treatment option to patients.