Gebe kadınlarda akut apandisitli hastalarda sistemik inflamasyon indekslerinin tanısal değeri ve hastanede kalış süresi ile korelasyonu

Year 2024, , 494 - 500, 30.09.2024

Bercis İmge Uçar , Muhammed Alperen Taş

https://doi.org/10.18663/tjcl.1445438

Abstract

Amaç: Gebelik sırasında meydana gelen fizyolojik ve anatomik değişiklikler, akut apandisit (AA) tanısını zorlaştırabilir. Bu çalışmada gebe kadınlarda AA'yı ayırt etmede sistemik inflamasyon indekslerinin tanısal performansının değerlendirilmesi ve hastanede kalış süresi ile ilişkisinin değerlendirilmesi amaçlandı.
Gereç ve Yöntemler: Bu retrospektif çalışma, apendektomi uygulanan 32 gebe hasta ile 32 sağlıklı gebe (kontrol grubu) üzerinde gerçekleştirilmiştir. Sistemik inflamasyon indeksleri, nötrofil (N), trombosit (P) ve lenfosit (L) düzeylerine göre şu şekilde hesaplanmıştır: nötrofil-lenfosit oranı (NLR) = N/L; trombosit-lenfosit oranı (PLR) = P/L; sistemik immün-inflamasyon indeksi (SII) = (N×P)/L.
Bulgular: AA grubunda kontrol grubuna kıyasla PLR (30.9 vs. 22.4, p = 0.035), NLR (6.1 vs. 3.5, p < 0.001) ve SII (1370 vs. 807, p < 0.001) değerleri daha yüksek bulunmuştur. Sistemik inflamasyon indeksleri, Alvarado skoru ve hastanede kalış süresi ile pozitif korelasyon göstermiştir. SII, NLR ve PLR'ye göre AA'yı öngörmede daha yüksek tanısal performans sergilemiştir. AA'yı öngörmede SII için eşik değer >1316 olup, duyarlılık %85.8 ve özgüllük %72.5 olarak belirlenmiştir.
Sonuç: Sistemik inflamasyon indeksleri, özellikle SII, gebelerde AA'yı ayırt etmede güçlü tanısal bir değere sahiptir. SII'nin hem Alvarado skoru hem de hastanede kalış süresi ile korelasyon göstererek NLR ve PLR'ye göre üstün doğruluk gösterdiği ve tanı ve prognoz belirteci olarak yararlı olduğunu düşündürmektedir.

Keywords

akut apandisit, Alvarado skoru, gebelik, sistemik inflamasyon indeksleri, sistemik immün-inflamasyon indeksi

Project Number

2024-11

The diagnostic value of systemic inflammation indices in pregnant women with acute appendicitis and their relationship with the duration of hospital stay

Abstract

Aim: Physiological and anatomical changes occurring during pregnancy can complicate the diagnosis of acute appendicitis (AA). This study aimed to evaluate the diagnostic performance of systemic inflammation indices in distinguishing AA in pregnant women and to assess their relationship with hospital stay duration.
Material and Methods: This retrospective study encompassed 32 pregnant patients who underwent appendectomy and 32 healthy pregnant (control group). Systemic inflammation indices were calculated based on neutrophil (N), platelet (P), and lymphocyte (L) levels as follows: The neutrophil-to-lymphocyte ratio (NLR) = N/L; the platelet-to-lymphocyte ratio (PLR) = P/L; systemic immune-inflammation index (SII) = (N×P)/L.
Results: The AA group had higher median levels of PLR (30.9 vs. 22.4, p = 0.035), NLR (6.1 vs. 3.5, p < 0.001), and SII (1370 vs. 807, p < 0.001) compared to the control group. Systemic inflammation indices showed a positive correlation with the Alvarado score and the length of hospital stay. SII values demonstrated superior diagnostic performance in predicting AA compared to NLR and PLR values. The threshold value for SII in predicting AA was identified as >1316, with a sensitivity of 85.8% and a specificity of 72.5%.
Conclusions: Systemic inflammation indices, particularly SII, demonstrate strong diagnostic value in distinguishing AA in pregnant women. SII demonstrated superior accuracy over NLR and PLR, correlating with both the Alvarado score and hospital stay, suggesting its utility as a diagnostic and prognostic marker.

Keywords

acute appendicitis, Alvarado score, pregnancy, systemic inflammation indices, systemic immune-inflammation index

Project Number

2024-11

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