The role of red cell distribution width in the diagnosis of acute appendicitis: a retrospective case-controlled study

Abstract

PurposeThe aim of this study was to seek whether red cell distribution width (RDW) has a role in the diagnosis of acute appendicitis. It was also aimed to show the relationship of RDW with leukocyte count and C-reactive protein (CRP) level.MethodsThis study was conducted via retrospective assessment of the hospital records of the adult patients who were operated for acute appendicitis between January 2010 and February 2013 and had a pathology report that confirmed the diagnosis of acute appendicitis. The patients in the control group were selected from healthy adults of similar age who applied to check-up clinic. Age, gender, leukocyte count, CRP, and RDW values were recorded. This study is a case controlled retrospective clinical study.ResultsA total of 590 patients in the acute appendicitis group and 121 patients in the control group were included, making up a total of 711 subjects. The mean RDW levels were 15.4 ± 1.5% in the acute appendicitis group, while 15.9 ± 1.4% in the control group. CRP, leukocyte count were significantly higher in the acute appendicitis group, and RDW level were significantly lower in the acute appendicitis group (p < 0.001, p < 0.001, p = 0.001, respectively). RDW, leukocyte count, and CRP had a sensitivity and specificity of 47% and 67%; 91% and 74%; and 97% and 41%, respectively in acute appendicitis. RDW was not correlated with CRP and leukocyte levels. However, we found a correlation between CRP and leukocyte levels.ConclusionRDW level was lower in patients with acute appendicitis. The magnitude of difference in RDW seen between acute appendicitis and controls was so slight as to be of no utility in diagnostic testing.

Mean platelet volume, red cell distribution width, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in the diagnosis acute appendicitis

“…Additionally, It was found to be related to mortality and other severe adverse outcomes in infectious diseases (28). Nowadays, different authors have been studied as an inflammatory marker in AA (8,15,16) however the results are limited and contradictory. Narci et al (15) observed that RDW levels were significantly lower in cases with AA than healthy subjects.…”

“…Nowadays, different authors have been studied as an inflammatory marker in AA (8,15,16) however the results are limited and contradictory. Narci et al (15) observed that RDW levels were significantly lower in cases with AA than healthy subjects. In contrast, Bozlu et al (16) found the higher levels of RDW in children with AA compared with control groups.…”

“…Different studies have reported that increased RDW levels, even within the normal reference range, were associated with unfavorable clinical outcomes in cases with cardiovascular diseases, type 2 diabetes mellitus, pulmonary thromboembolism and ischemic stroke (13,14). Nowadays, a number of variables have been studied as an inflammatory marker in AA (8,15,16) however the results are inconsistent. Several authors have reported that an increased leukocyte count is used as diagnostic tool in AA.…”

Efficacy of Use of Red Cell Distribution Width as a Diagnostic Marker in Acute Appendicitis

“…Şenol et al (5) emphasized that a high RDW value on admission is an independent marker of mortality in patients with acute pancreatitis and might be used as a prognostic marker. Narci et al (33) stated that RDW levels in an AA group were low when compared with a control group, and they therefore cannot be used as a suitable marker. They detected a sensitivity of 47% and a specificity of 67% when the optimum cut-off value was 15.6% according to ROC analysis.…”

Can red cell distribution width be used as a predictor of acute cholecystitis?

“…Increased RDW-level has been shown to be associated with elevated CRP, erythrocyte sedimentation rate, and interleukin-6 levels (22, 25, 27). Narci et al (28) determined decreased RDW level in patients with acute appendicitis with a sensitivity and specificity of 47% and 67%, respectively. However, the difference was so slight that it was concluded that RDW could not be used in diagnostic testing.…”