Success of inflammatory markers in prediction of the severity of acute cholecystitis

Success of Inflammatory Markers in Prediction of The Severity of Acute Cholecystitis INTRODUCTION AND AIM: In this study, it was aimed to reveal the success of the desired inflammatory marker results at the time of admission in predicting the severity of acute cholecystitis in patients who applied to the emergency department with the complaint of abdominal pain and were diagnosed with acute cholecystitis. MATERIALS AND METHODS: This retrospective and descriptive study was conducted with 301 patients who were diagnosed with acute cholecystitis and admitted to Sakarya University Training and Research Hospital Emergency Medicine Clinic with abdominal pain. The data of the patients were recorded. Patients were divided into three groups according to Tokyo Manual 18(TK 18) severity (Grade 1: Mild, Grade 2: Moderate and Grade 3: Severe). The data were analyzed statistically and p<0.05 values were considered significant. RESULTS: 157 (52.2%) of the patients were male and their mean age was 58.41±16.51. According to Grade 1, in Grade 2, leukocyte (p<0.001), neutrophil (p<0.001), lymphocyte (p<0.001), RDW (p=0.043) and monocytin (p=0.036); according to Grade 1, in Grade 3, leukocyte (p<0.001), neutrophil (p<0.001), Neutrophil Lymphocyte Ratio (NLR) (p<0.001), Platelet Lymphocyte Ratio (TLR (p=0.002), INR ( p<0.001), CRP (p<0.001) and glucose (p=0.014); according to Grade 2, in Grade 3, neutrophil (p=0.011), NLR (p<0.003), TLR (p=0.016), INR (p<0.001) and CRP (p= 0.006) was found to be significantly higher. Albumin was found to be significantly lower in Grade 1 and Grade 2 (respectively; p<0.001, p=0.006) compared to Grade 3, inversely proportional to the increasing severity. CONCLUSION: The most valuable parameter in predicting the severity of acute cholecystitis is the neutrophil. However, elevations in lymphocyte, RDW and monocyte values can be used to predict the transition from Grade 1 to Grade 2, and increases in NLR, TLO, INR and CRP values can be used in the transition from Grade 2 to Grade 3. Albumin decline indicates that the severity is Grade 3. Key Words: Abdominal Pain, Acute Cholecystitis, Emergency Room, İnflammatory Markers, Tokyo Guidelines.