Yıl: 2022 Cilt: 28 Sayı: 3 Sayfa Aralığı: 375 - 381 Metin Dili: İngilizce DOI: 10.14744/tjtes.2021.41347 İndeks Tarihi: 03-11-2022

The role of immature granulocyte in the early prediction of acute perforated and nonperforated appendicitis in children

Öz:
BACKGROUND: Acute appendicitis (AA) is the most common reason for pediatric abdominal surgery in the world. Despite ad- vances in science and technology, diagnosing AA is still difficult today, and complications are common as a result. The early prediction of complicated appendicitis is of great importance for the surgical planning, further treatments, and predicting the course of disease. The immature granulocyte (IG) is a new and more effective marker in predicting the severity of inflammation than traditional markers. Our aim is to determine the effectiveness of IG% in the diagnosis and severity of AA. METHODS: Eighty-eight patients diagnosed with AA and a control group of fifty-eight healthy children were included in this prospec- tive study. Patients with pathologically confirmed AA were divided into two subgroups: acute simple appendicitis (ASA) and acute perforated appendicitis (APA). The demographic characteristics, white blood cell (WBC) count, neutrophil-to-lymphocyte ratio (NLR), mean platelet volume (MPV), IG%, and C-reactive protein (CRP) values were analyzed. Receiver operating characteristics (ROC) anal- ysis was used to compare the diagnostic accuracies and predictive performances. RESULTS: Patients with AA had higher IG%, WBC count, NLR, and MPV value than control group (p=0.28, p=0.22, p<0.001, p=0.001, respectively). Only IG% showed statistically significant difference from other inflammatory markers evaluated in ASA and APA patients (p<0.001). ROC analysis showed that IG% is a good predictor for the presence of APA at an optimal cut-off for IG being 0.2% (sensitivity 81.8%, specificity 85.2%, area under the ROC curve 0.83). CONCLUSION: In the present study, we demonstrated that AA patients with higher IG levels might be more likely to develop perforation. The IG values combined with a physical examination, imaging studies, and other laboratory tests may help clinicians to identify high-risk AA patients in the pediatric emergency department.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
0
0
0
  • 1. Bhangu A, Soreide K, Di Saverio S, Assarsson JH, Drake FT. Acute ap- pendicitis: Modern understanding of pathogenesis, diagnosis, and man- agement. Lancet 2015;386:1278–1287.
  • 2. Kulik DM, Uleryk EM, Maguire JL. Does this child have appendicitis? A systematic review of clinical prediction rules for children with acute abdominal pain. J Clin Epidemiol 2013;66:95–104.
  • 3. Singh M, Kadian YS, Rattan KN, Jangra B. Complicated appendicitis: Analysis of risk factors in children. Afr J Paediatr Surg 2014;11:109–13.
  • 4. Atema JJ, Gans SL, Beenen LF, Toorenvliet BR, Laurell H, Stoker J, et al. Accuracy of white blood cell count and C-reactive protein levels related to duration of symptoms in patients suspected of acute appendicitis. Acad Emerg Med 2015;22:1015–1024.
  • 5. Benito J, Acedo Y, Medrano L, Barcena E, Garay RP, Arri EA. Usefulness of new and traditional serum biomarkers in children with suspected ap- pendicitis. Am J Emerg Med 2016;34:871–6.
  • 6. Yazici M, Ozkisacik S, Oztan MO, Gürsoy H. Neutrophil/lympho- cyte ratio in the diagnosis of childhood appendicitis. Turk J Pediatr 2010;52:400–3.
  • 7. Ishizuka M, Shimizu T, Kubota K. Neutrophil-to-lymphocyte ratio has a close association with gangrenous appendicitis in patients undergoing appendectomy. Int Surg 2012;97:299–304.
  • 8. Boshnak N, Boshnaq M, Elgohary H. Evaluation of platelet ındices and red cell distribution width as newbiomarkers for the diagnosis of acute appendicitis. J Invest Surg 2018;31:12–9.
  • 9. Senthilnayagam B, Kumar T, Sukumaran J, Jeya M, Rao KR. Automated measurement of immature granulocytes: Performance characteristics and utility in routine clinical practice. Patholog Res Int 2012;2012:483670.
  • 10. Ansari–Lari MA, Kickler TS, Borowitz MJ. Immature granulocyte mea- surement using the Sysmex XE-2100. Relationship to infection and sep- sis. Am J Clin Pathol 2003;120:795–9.
  • 11. Park BH, Kang YA, Park MS, Jung WJ, Lee SH, Lee SK, et al. Delta neu- trophil index as an early marker of disease severity in critically ill patients with sepsis. BMC Infect Dis 2011;11:299.
  • 12. Ünal Y. A new and early marker in the diagnosis of acute complicated appendicitis: İmmature granulocytes. Ulus Travma Acil Cerrahi Derg 2018;24:434–9.
  • 13. Samuel M. Pediatric appendicitis score. J Pediatr Surg 2002;37:877–81.
  • 14. Debnath J, Kumar R, Mathur A, Sharma P, Kumar N, Shridar N, et al. On the role of ultrasonography and CT scan in the diagnosis of acute appendicitis. Indian J Surg 2015;77:221–6.
  • 15. Pinto F, Pinto A, Russo A, Coppolino F, Bracale R, Fonio P, et al. Accu- racy of ultrasonography in the diagnosis of acute appendicitis in adult patients: Review of the literature. Crit Ultrasound J 2013;5 Suppl 1:S2.
  • 16. Wray CJ, Kao LS, Millas SG, Tsao K, Ko TC. Acute appendicitis: Contro- versies in diagnosis and management. Curr Probl Surg 2013;50:54–86. 17. Andersson RE. Meta-analysis of the clinical and laboratory diagnosis of appendicitis. Br J Surg 2004;91:28–37.
  • 18. Yu CW, Juan LI, Wu MH, Shen CJ, Wu JY, Lee CC. Systematic review and meta-analysis of the diagnostic accuracy of procalcitonin, C-reactive protein and white blood cell count for suspected acute appendicitis. Br J Surg 2013;100:322–9.
  • 19. Birchley D. Patients with clinical acute appendicitis should have pre-op- erative full blood count and C-reactive protein assays. Ann R Coll Surg Engl 2006;88:27–32.
  • 20. Calder JD, Gajraj H. Recent advances in the diagnosis and treatment of acute appendicitis. Br J Hosp Med 1995;54:129–33.
  • 21. Aygun A, Katipoglu B, Imamoglu M, Demir S, Yadigaroglu M, Tatli O, et al. Diagnostic value of plasma pentraxin-3 in acute appendicitis. J Invest Surg 2019;32:143−8.
  • 22. Kahramanca S, Ozgehan G, Seker D, Gökce EI, Seker G, Tunç G, et al. Neutrophil-to-lymphocyte ratio as a predictor of acute appendicitis. Ulus Travma Acil Cerrahi Derg 2014;20:19–22.
  • 23. Jung SK, Rhee DY, Lee WJ, Woo SH, Seol SH, Kim DH, et al. Neu- trophil-to-lymphocyte count ratio is associated with perforated appen- dicitis in elderly patients of emergency department. Aging Clin Exp Res 2017;29:529–36.
  • 24. Celik B, Nalcacioglu H, Ozcatal M,Torun YA. Role of neutrophil-to- lymphocyte ratio and platelet-to-lymphocyte ratio in identifying compli- cated appendicitis in the pediatric emergency department. Ulus Travma Acil Cerrahi Derg 2019;25:222–228.
  • 25. Yazar FM, Bakacak M, Emre A, Urfalioglu A, Serin S, Cengiz E, et al. Predictive role of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios for diagnosis of acute appendicitis during pregnancy. Kaohsiung J Med Sci. 2015;31(11):591–6.
  • 26. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: A link between thrombosis and inflammation? Curr Pharm Des. 2011;17:47–58.
  • 27. Danese S, de la Motte Cd C, Fiocchi C. Platelets in inflammatory bowel disease: Clinical, pathogenic, and therapeutic implications. Am J Gas- troenterol 2004;99:938–45.
  • 28. Nazik S, Avci V, Kiraz ZK. Ischemia-modified albumin and other in- flammatory markers in the diagnosis of appendicitis in children. Ulus Travma Acil Cerrahi Derg. 2017;23:317–21.
  • 29. Erdag ÇE, Coskun TF, Biçer S, Ugras M, Giray T, Kaspar Ç, et al. Can mean platelet volume be used as a marker in children with acute appen- dicitis? J Pediatr Emerg Intensive Care Med 2017;4:17–21.
  • 30. Narci H, Turk E, Karagulle E, Togan T, Karabulut K. the role of mean platelet volume in the diagnosis of acute appendicitis: A retrospective case-controlled study. Iran Red Crescent Med J 2013;15:e11934.
  • 31. Wu HP, Lin CY, Chang CF, Chang YC, Huang CY. Predictive value of C-reactive protein at different cutoff levels in acute appendicitis. Am J Emerg Med 2005;23:449–53.
  • 32. Yang HR, Wang YC, Chung PK, Chen WK, Jeng LB, Chen RJ. Labora- tory tests in patients with acute appendicitis. ANZ J Surg 2006;76:71–4.
  • 33. Beltran MA, Almonacid J, Vicencio A, Gutierrez J, Cruces KS, Cumsille MA. Predictive value of white blood cell count and C-reactive protein in children with appendicitis. J Pediatr Surg 2007;42:1208–14.
  • 34. Howell JM, Eddy OL, Lukens TW, Thiessen ME, Weingart SD, Decker WW. Clinical policy: Critical issues in the evaluation and management of emergency department patients with suspected appendicitis. Ann Emerg Med 2010;55:71–116.
  • 35. Lipiński M, Rydzewska G. Immature granulocytes predict severe acute pancreatitis independently of systemic inflammatory response syndrome. Prz Gastroenterol 2017;12:140–4.
  • 36. Pavare J, Grope I, Kalnins I, Gardovska D. High-mobility group box-1 protein, lipopolysaccharide-binding protein, interleukin-6 and C-reactive rotein in children with community acquired infections and bacteraemi- a-a prospective study. BMC Infect Dis 2010;10:28.
  • 37. Shin DH, Cho YS, Kim YS, Ahn HC, Oh YT, Park SO, et al. Delta neutrophil index: A reliable marker to differentiate perforated appen- dicitis from non-perforated appendicitis in the elderly. J Clin Lab Anal 2018;32:e22177.
  • 38. Mathews EK, Griffin RL, Mortellaro V, Beierle EA, Harmon CM, Chen MK, et al. Utility of immature granulocyte percentage in pediatric appen- dicitis. J Surg Res 2014;190:230–4.
  • 39. Shin DH, Cho YS, Cho GC, Ahn HC, Park SM, Lim SW, et al. Delta neutrophil index as an early predictor of acute appendicitis and acute complicated appendicitis in adults. World J Emerg Surg 2017;12:32.
APA DOĞAN M, Gurleyen B (2022). The role of immature granulocyte in the early prediction of acute perforated and nonperforated appendicitis in children. , 375 - 381. 10.14744/tjtes.2021.41347
Chicago DOĞAN MURAT,Gurleyen Bercem The role of immature granulocyte in the early prediction of acute perforated and nonperforated appendicitis in children. (2022): 375 - 381. 10.14744/tjtes.2021.41347
MLA DOĞAN MURAT,Gurleyen Bercem The role of immature granulocyte in the early prediction of acute perforated and nonperforated appendicitis in children. , 2022, ss.375 - 381. 10.14744/tjtes.2021.41347
AMA DOĞAN M,Gurleyen B The role of immature granulocyte in the early prediction of acute perforated and nonperforated appendicitis in children. . 2022; 375 - 381. 10.14744/tjtes.2021.41347
Vancouver DOĞAN M,Gurleyen B The role of immature granulocyte in the early prediction of acute perforated and nonperforated appendicitis in children. . 2022; 375 - 381. 10.14744/tjtes.2021.41347
IEEE DOĞAN M,Gurleyen B "The role of immature granulocyte in the early prediction of acute perforated and nonperforated appendicitis in children." , ss.375 - 381, 2022. 10.14744/tjtes.2021.41347
ISNAD DOĞAN, MURAT - Gurleyen, Bercem. "The role of immature granulocyte in the early prediction of acute perforated and nonperforated appendicitis in children". (2022), 375-381. https://doi.org/10.14744/tjtes.2021.41347
APA DOĞAN M, Gurleyen B (2022). The role of immature granulocyte in the early prediction of acute perforated and nonperforated appendicitis in children. Ulusal Travma ve Acil Cerrahi Dergisi, 28(3), 375 - 381. 10.14744/tjtes.2021.41347
Chicago DOĞAN MURAT,Gurleyen Bercem The role of immature granulocyte in the early prediction of acute perforated and nonperforated appendicitis in children. Ulusal Travma ve Acil Cerrahi Dergisi 28, no.3 (2022): 375 - 381. 10.14744/tjtes.2021.41347
MLA DOĞAN MURAT,Gurleyen Bercem The role of immature granulocyte in the early prediction of acute perforated and nonperforated appendicitis in children. Ulusal Travma ve Acil Cerrahi Dergisi, vol.28, no.3, 2022, ss.375 - 381. 10.14744/tjtes.2021.41347
AMA DOĞAN M,Gurleyen B The role of immature granulocyte in the early prediction of acute perforated and nonperforated appendicitis in children. Ulusal Travma ve Acil Cerrahi Dergisi. 2022; 28(3): 375 - 381. 10.14744/tjtes.2021.41347
Vancouver DOĞAN M,Gurleyen B The role of immature granulocyte in the early prediction of acute perforated and nonperforated appendicitis in children. Ulusal Travma ve Acil Cerrahi Dergisi. 2022; 28(3): 375 - 381. 10.14744/tjtes.2021.41347
IEEE DOĞAN M,Gurleyen B "The role of immature granulocyte in the early prediction of acute perforated and nonperforated appendicitis in children." Ulusal Travma ve Acil Cerrahi Dergisi, 28, ss.375 - 381, 2022. 10.14744/tjtes.2021.41347
ISNAD DOĞAN, MURAT - Gurleyen, Bercem. "The role of immature granulocyte in the early prediction of acute perforated and nonperforated appendicitis in children". Ulusal Travma ve Acil Cerrahi Dergisi 28/3 (2022), 375-381. https://doi.org/10.14744/tjtes.2021.41347