The Systemic Inflammatory Response in Patients with Appendicitis: a Progressive Phenomenon

Beltrán, Marcelo A.

doi:10.1007/s12262-014-1134-2

Cited by 7 publications

(5 citation statements)

References 26 publications

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“…WBCC value, CRP value, and NE% value are higher in complicated AA than in uncomplicated AA, in accordance with most previous reports (1,6,8,15,19,34). And our data also support this view.…”

Section: Discussionsupporting

confidence: 93%

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Inflammatory Markers and Duration of Symptoms Have a Close Connection With Diagnosis and Staging of Acute Appendicitis in Children

et al. 2021

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Background: For children with acute appendicitis (AA), a clear diagnosis is a challenge. The purpose of this study is to explore whether inflammatory markers in the blood combined with symptom duration are helpful in the diagnosis of acute appendicitis and in predicting the severity of acute appendicitis.Methods: All the selected patients underwent appendectomy between November 10, 2011 and November 15, 2019, in whom preoperative WBCC, CRP, and NE% had been measured in a short time. All patients were divided into two groups: uncomplicated AA and complicated AA, postoperatively.Results: For our standards, 813 patients were selected, 442 of them had complicated AA. The mean [standard deviation (SD)] age for the uncomplicated AA group was 9.78 ± 2.02 years and for the complicated AA group was 9.69 ± 2.16 years (P = 0.55). Elevated WBCC, CRP, and NE% had a higher relatively sensitivity in complicated AA than uncomplicated AA especially when WBCC, CRP, and NE% were at normal levels, which had a sensitivity of 100% in uncomplicated AA, but this only applied to nine patients. CRP values were significantly different in three time groups, whether uncomplicated or complicated AA.Conclusion: The combination of WBCC, CRP, and NE% values is very sensitive for the diagnosis of acute appendicitis, and when we predict complicated AA using the CRP value, we also need to consider the time of symptom onset.

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“…WBCC value, CRP value, and NE% value are higher in complicated AA than in uncomplicated AA, in accordance with most previous reports (1,6,8,15,19,34). And our data also support this view.…”

Section: Discussionsupporting

confidence: 93%

“…Laboratory tests such as white blood cell count (WBCC) and C-reactive protein (CRP) have long been used to support clinical data in the decision-making process (1,5,(11)(12)(13). And neutrophil percentage is also used in the diagnosis of AA (14,15).…”

Section: Introductionmentioning

confidence: 99%

Inflammatory Markers and Duration of Symptoms Have a Close Connection With Diagnosis and Staging of Acute Appendicitis in Children

et al. 2021

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“…Many of our patients (42.8%) had symptoms lasting 24–48 h. However, although someone could believe that the inflammatory response in AA is progressive (the longer the duration of symptoms the worse the severity of AA) [ 36 ], in our multivariate analysis it was observed that patients with duration of symptoms less than 24 h were more likely to suffer from ACA, hence why this was included in our new score. This result could be explained by the fact that in small children AA is an uncommon disease that has a varied presentation and complications that can develop rapidly, and in our study our patients with ACA were statistically younger than the patients with AUA [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Predicting Complicated Appendicitis in Children: Pros and Cons of a New Score Combining Clinical Signs, Laboratory Values, and Ultrasound Images (CLU Score)

et al. 2023

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Background: This retrospective study aimed to combine the clinical signs, laboratory values, and ultrasound images of 199 children with acute appendicitis in order to create a new predictive score for complicated appendicitis in children. Methods: The study included children who had clinical examination of abdominal pain (description of pain, anorexia, body temperature, nausea or vomiting, duration of symptoms), laboratory findings on admission (white blood cell, platelets, neutrophils, C-reactive protein), preoperative abdominal ultrasound, and histopathological report after an operation for appendicitis in their records during the period from January 2016 to February 2022. Results: According to the statistical analysis of the values using multivariate logistic regression models, the patients with appendiceal diameter ≥ 8.45 mm, no target sign appearance, appendicolith, abscess, peritonitis, neutrophils ≥ 78.95%, C-reactive protein ≥ 1.99 mg/dL, body temperature ≥ 38 °C, pain migration to right lower quadrant, and duration of symptoms < 24 h were more likely to suffer from complicated appendicitis. The new score was comprised of the 10 variables that were found statistically significant in the multivariate logistic model. Each of these variables was assigned a score of 1 due to the values that were associated with complicated appendicitis. Conclusions: A cutoff value of ≥4 has been a good indicator of the final score. The sensitivity with the usage of this score is 81.1%, the specificity 82.4%, the PPV 73.2%, the NPV approaches 88% and finally the accuracy is 81.9%. Also, the pros and cons of this score are discussed in this study.

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“…However, computed tomography also involves exposure to ionizing radiation for children. Because appendicitis causes a systemic inflammatory response, 10 simple, widely available, and inexpensive inflammatory tests are still used to support the clinical diagnosis of appendicitis. Several studies have so far investigated a variety of inflammatory biomarkers associated with appendicitis, and numerous conflicting results have been obtained from these studies.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Monocyte-to-Lymphocyte Ratio Against Other Biomarkers in Children With Appendicitis

et al. 2021

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Objectives: This study aimed to investigate diagnostic value of monocyte-tolymphocyte ratio as a novel biomarker in children with appendicitis and to compare with other biomarkers.Methods: A total of 683 children were included in this retrospective study.Patients were categorized as acute appendicitis (AA, n = 254), perforated appendicitis (PA, n = 82), nonspecific abdominal pain (NAP, n = 197), and control (n = 150). The groups were compared for demographics, duration of symptoms, monocyte-to-lymphocyte ratio (MLR), platelet-tolymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), white blood cell count, neutrophil percentage (NP), C-reactive protein (CRP), mean platelet volume, and sodium level.Results: There was a significant difference between all groups for MLR, PLR, and CRP. White blood cell count, NP, and NLR were significantly increased in patients with appendicitis, but there was no significant difference in the differential diagnosis between PA and AA. Sodium levels significantly decreased in patients with appendicitis. No statistically significance was determined between all groups in term of mean platelet volume. Among the biomarkers, MLR showed the highest diagnostic value (area under the receiver operator characteristic curve = 0.798) for AA, while CRP showed excellent diagnostic value (area under the receiver operator characteristic curve = 0.897) for PA.Conclusions: To our knowledge, this is the first study showing that MLR is a valuable parameter to differentiate patients with and without appendicitis. White blood cell, NP, and NLR are also useful parameters. On the other hand, an increased CRP level and hyponatremia are indicators of PA.

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The Systemic Inflammatory Response in Patients with Appendicitis: a Progressive Phenomenon

Cited by 7 publications

References 26 publications

Inflammatory Markers and Duration of Symptoms Have a Close Connection With Diagnosis and Staging of Acute Appendicitis in Children

Inflammatory Markers and Duration of Symptoms Have a Close Connection With Diagnosis and Staging of Acute Appendicitis in Children

Predicting Complicated Appendicitis in Children: Pros and Cons of a New Score Combining Clinical Signs, Laboratory Values, and Ultrasound Images (CLU Score)

Diagnostic Value of Monocyte-to-Lymphocyte Ratio Against Other Biomarkers in Children With Appendicitis

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