Retrospective analysis of patients diagnosed with acute appendicitis in the emergency department

ABSTRACT Objective: In our study, we aimed to evaluate the routine parameters of patients diagnosed with acute appendicitis at emergency service admission, and to determine whether they show the severity of complications and the disease. Material and Method: This study is a retrospective study of patients who were diagnosed with acute appendicitis in the emergency department between January 1, 2019, and December 31, 2020. Demographic data such as the age and gender of the patients, laboratory values obtained from blood tests, and AIR and Alvarado scores calculated in the emergency department were recorded. As a result of the data obtained, we divided the patients into two groups complicated appendicitis (CA) and non-complicated appendicitis (NCA) cases. Results: Of the 223 patients included in our study, 63.7% were male and the mean age was calculated as 37.5 ± 16.8 years. It was determined that complicated appendicitis cases had statistically significantly higher NLR, PLR, CRP, SII, WBC, neutrophil levels, and lower LCRP, lymphocyte count in terms of hematological parameters. When we compared the biochemical parameters, it was observed that the complicated appendicitis cases had statistically significantly higher urea, creatinine, total bilirubin, and indirect bilirubin levels. In addition, complicated appendicitis cases were found to have statistically significantly higher AIR and Alvarado scores. When we examined the sensitivity and specificity of the AIR Score, Alvarado Score, LCRP, and NLR parameters in detecting complicated appendicitis we found them to be for AIR Score 85.9%, 47.9% (cut-off ≥6, 95% CI, 0.675-0.821, AUC: 0.748; p:0.00), for Alvarado score 80.6%, 44.5% (cut-off ≥6, 95% CI, 0.527-0.683, AUC: 0.605; p:0.10), for LCRP ratio 78.9%, 89.7% (cut-off ≤1, 95% CI, 0.711-0.847, AUC: 0.782; p: 0.00), for NLR ratio 64.9%, 77.1% (cut-off ≥8.2, 95% CI, 0.585-0.743, AUC: 0.664; p: 0.01). Conclusion: Inflammatory markers are thought to be valuable parameters in the differentiation of complicated and non-complicated appendicitis. LCRP, SII, NLR, and PLR have been found useful parameters in differentiating complicated and non-complicated appendicitis in this study.