Evaluation of the relationship of laboratory values with age in the diagnosis of acute appendicitis and its role in predicting complicated appendicitis by age

Aim: Acute appendicitis is one of the most common causes of acute abdomen and one of the most common indications for emergency abdominal surgery worldwide. It affects all age and gender groups. In this study, it was aimed to examine the relationship between laboratory markers and histopathological diagnosis among different age groups. It was aimed to examine the differences between age groups in acute appendicitis, such as histopathological diagnosis, mortality, need for ICU, and length of hospitalization. It is aimed to use laboratory data to differentiate complicated appendicitis and simple appendicitis. At the same time, it was aimed to investigate the place of laboratory data in predicting complicated appendicitis. Materials and Methods: This retrospective study included 978 patients over the age of 2 who were diagnosed with acute appendicitis during the five-year study period. The files and pathology results of the patients were reviewed retrospectively through the hospital data system. As a result of pathological examinations, the patients were divided into two as positive appendectomy group and negative appendectomy group. The patients in the positive appendectomy group were divided into two subgroups as simple appendicitis and complicated appendicitis. Patients were divided into groups as 2-17 (group A), 18-64 (group B), 65 and over (group C) according to their age at the time of admission to the emergency department. Age, gender, comorbidities, laboratory values, length of hospital stay, need for intensive care and 30-day mortality of the patients included in the study were recorded in the patient registration form. Obtained data were compared between groups using appropriate statistical methods. Results: 785 (80.3%) of 978 patients evaluated within the scope of the study fit the criteria. The mean age of the patients was 23.7±18.1 years. Of the patients, 479 (61.0%) were male and 306 (39.0%) were female. Looking at age groups; 388 (49.4%) patients were in the 2-17 age group, 363 (46.2%) patients were in the 18-64 age group, and 34 (4.3%) patients were 65 years or older. WBC, neutrophil, NLR, PLR, NWR, CRP, ALT, direct bilirubin values and length of stay were found to be statistically significantly higher and lymphocyte levels were found to be significantly lower in complicated appendicitis cases compared to simple appendicitis cases. There is no significant difference in terms of platelet, RDW, MPV, procalcitonin, AST and total bilirubin values. The need for intensive care and 30-day mortality in complicated appendicitis cases are statistically significantly higher than in simple appendicitis cases. The incidence of complicated appendicitis, the need for intensive care, and the presence of 30-day mortality in people aged 65 and over are statistically significantly higher than other groups. There is a statistically significant difference between age groups in terms of WBC, neutrophil, lymphocyte, platelet, RDW, MPV, NLR, PLR, NWR, CRP, ALT parameters and length of stay. There was no difference between the groups in terms of procalcitonin, AST, direct bilirubin and total bilirubin. NLR, PLR and CRP variables were determined as factors affecting complicated appendicitis. Conclusion: Patients in the geriatric age group have a higher CRP value, KA rate, longer length of follow-up in hospital, need for ICU, and mortality rate than patients in other age groups. There is no difference between the patients in the pediatric age group and the patients in the 18-64 age group in terms of length of follow-up in hospital, ICU need and mortality. NLR, PLR and CRP variables were found to be risk factors for complicated appendicitis in the study. Key words: Emergency service; acute appendicitis; Laboratory Values; Age Groups