Can immature granulocytes be used as a predictive new marker in the diagnosis of acute cholecystitis?

Abstract

Aim: Acute cholecystitis (AC) is one of the most common acute surgical diseases in the emergency department (ED). The aim of this study was to investigate the efficacy of inflammatory parameters as immature granulocyte count (IGC) and immature granulocyte percentage (IG%) in the diagnosis of AC.Material and methods: This retrospective and observational study consisted of patients, diagnosed with AC, who were admitted to a tertiary ED with abdominal pain between March 2019 and April 2021. The effectiveness of IGC and IG% in the diagnosis of AC was examined by comparing the results with the control group (CG).Results: A total of 493 patients were included in the study. 270 patients were in the AC group, 223 patients were in the CG. IG% and IGC were found to be significantly higher in the AC group than in the CG (0.5 (0.32) vs. 0.4 (0.2); 0.06 (0.08) vs. 0.03 (0.03); p<0.001, p<0.001 respectively). It has been shown that IGC, at a cut-off value of 0.03, predicts the diagnosis of AC with 72.1% sensitivity and 55.5% specificity. On the other hand, IG%, at a cut-off value of 0.45, predicts the diagnosis of AC with 53.2% sensitivity and 72.7% specificity (AUC [0.717 (0.672-0.762); 0.692 (0.645-0.738)], respectively p<0.001, p<0.001).Conclusions: In conclusion, IGC and IG% can be used as a useful inflammatory parameter in the diagnosis of AC in patients admitted to the emergency department.

The role of ischemia-modified albumin, presepsin, delta neutrophil index, and inflammatory markers in diagnosing acute cholecystitis

“…Given the roles of inflammation, oxidative stress, and ischemia in the disease's pathophysiology, research into the diagnostic value of markers related to these processes is crucial. [1,2,3,4] In the study conducted by Korkut et al, [17] the delta neutrophil index and delta neutrophil count were found to be significantly higher in patients presenting to the emergency department and diagnosed with AC compared to those not diagnosed with AC. The findings included a WBC count of 12.84±5.42×10 This research determined the cutoff values, sensitivity, specificity, positive LR, negative LR, and hemogram values of inflammatory markers in patients diagnosed with AC, presenting these findings in the results section.…”

“…Patient selection was based on the diagnostic criteria for acute cholecystitis. According to the Acute Cholecystitis Diagnostic Criteria, [4,17] patients showing one of the local signs of inflammation, such as Murphy's sign or a mass, pain, or tenderness in the right upper quadrant, along with one of the systemic signs of inflammation, such as fever, elevated white blood cell count, and elevated C-reactive protein level, were diagnosed with acute cholecystitis. Patients in whom suspected clinical findings were confirmed by diagnostic imaging were also diagnosed with acute cholecystitis.…”