Evaluation of the predictive power of laboratory markers in the diagnosis of acute appendicitis in the elderly

INTRODUCTION[|]The aim of this study was to analyze the predictive value of preoperative laboratory findings in acute appendicitis in geriatric patients aged >65 years.[¤]METHODS[|] We enrolled a total of 4121 patients. A retrospective evaluation of the demographic features was made using pre...

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Main Authors: Savaş Bayrak, Cihad Tatar, Ekrem Çakar, Sukru Colak, Mehmet Emin Gunes, Kemal Tekeşin, Bünyamin Gürbulak, Erdem Kinaci, Mert Mahsuni Sevinc
Format: Article
Language:English
Published: KARE Publishing 2019-09-01
Series:İstanbul Kuzey Klinikleri
Subjects:
Online Access:https://jag.journalagent.com/z4/download_fulltext.asp?pdir=nci&un=NCI-93457
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author Savaş Bayrak
Cihad Tatar
Ekrem Çakar
Sukru Colak
Mehmet Emin Gunes
Kemal Tekeşin
Bünyamin Gürbulak
Erdem Kinaci
Mert Mahsuni Sevinc
author_facet Savaş Bayrak
Cihad Tatar
Ekrem Çakar
Sukru Colak
Mehmet Emin Gunes
Kemal Tekeşin
Bünyamin Gürbulak
Erdem Kinaci
Mert Mahsuni Sevinc
author_sort Savaş Bayrak
collection DOAJ
description INTRODUCTION[|]The aim of this study was to analyze the predictive value of preoperative laboratory findings in acute appendicitis in geriatric patients aged >65 years.[¤]METHODS[|] We enrolled a total of 4121 patients. A retrospective evaluation of the demographic features was made using preoperative laboratory values such as the white blood cell (WBC), neutrophil, and lymphocyte counts; platelet counts; the mean platelet volume and bilirubin values; and postoperative pathological data of the patients from the electronic file system. The neutrophil-to-WBC and neutrophil-to-lymphocyte ratios were calculated. Patients were divided into two groups, as geriatric (≥65 years old, n=140) and non-geriatric (<65 years old, n=3981).[¤]RESULTS[|]The white blood cell and lymphocyte counts, and the neutrophil-to-WBC ratio, were significantly higher in the non-geriatric group (p<0.001, p=0.013, and p=0.021, respectively). The neutrophil and platelet counts were higher in the non-geriatric group, but this difference was not statistically significant (p=0.073 and p=0.072, respectively). A higher neutrophil-to-lymphocyte ratio was determined in the geriatric group, but the difference was not significant (p=0.176). According to the optimumal cutoff value of 12.11×103/µL for WBC, specificity and sensitivity values of 65.4% and 57.9% were calculated, respectively; the AUC value was 0.632+-0.024 (p<0.001). A receiver operating characteristic (ROC) analysis was used to calculate the optimum cutoff values of neutrophil-to-WBC ratio, lymphocyte, and the mean platelet volume, but the diagnostic accuracy of these tests was inadequate with an AUC of <0.6.[¤]DISCUSSION AND CONCLUSION[|]WBC values >12.11×103/µL were predictive of acute appendicitis in geriatric patients. The other parameters were not predictive, and further studies are required.[¤]
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spelling doaj.art-55a7a53eb8dc482da2a09952770674dd2023-02-15T16:21:45ZengKARE Publishingİstanbul Kuzey Klinikleri2148-49022019-09-016329330110.14744/nci.2019.93457NCI-93457Evaluation of the predictive power of laboratory markers in the diagnosis of acute appendicitis in the elderlySavaş Bayrak0Cihad Tatar1Ekrem Çakar2Sukru Colak3Mehmet Emin Gunes4Kemal Tekeşin5Bünyamin Gürbulak6Erdem Kinaci7Mert Mahsuni Sevinc8Department of General Surgery, Istanbul Training and Research Hospital, Istanbul, TurkeyDepartment of General Surgery, Istanbul Training and Research Hospital, Istanbul, TurkeyDepartment of General Surgery, Istanbul Training and Research Hospital, Istanbul, TurkeyDepartment of General Surgery, Istanbul Training and Research Hospital, Istanbul, TurkeyDepartment of General Surgery, Bakirkoy Sadi Konuk Training and Research Hospital, Istanbul, TurkeyDepartment of General Surgery, Umraniye Training and Research Hospital, Istanbul, TurkeyDepartment of General Surgery, Istanbul Training and Research Hospital, Istanbul, TurkeyDepartment of General Surgery, Istanbul Training and Research Hospital, Istanbul, TurkeyDepartment of General Surgery, Istanbul Training and Research Hospital, Istanbul, TurkeyINTRODUCTION[|]The aim of this study was to analyze the predictive value of preoperative laboratory findings in acute appendicitis in geriatric patients aged >65 years.[¤]METHODS[|] We enrolled a total of 4121 patients. A retrospective evaluation of the demographic features was made using preoperative laboratory values such as the white blood cell (WBC), neutrophil, and lymphocyte counts; platelet counts; the mean platelet volume and bilirubin values; and postoperative pathological data of the patients from the electronic file system. The neutrophil-to-WBC and neutrophil-to-lymphocyte ratios were calculated. Patients were divided into two groups, as geriatric (≥65 years old, n=140) and non-geriatric (<65 years old, n=3981).[¤]RESULTS[|]The white blood cell and lymphocyte counts, and the neutrophil-to-WBC ratio, were significantly higher in the non-geriatric group (p<0.001, p=0.013, and p=0.021, respectively). The neutrophil and platelet counts were higher in the non-geriatric group, but this difference was not statistically significant (p=0.073 and p=0.072, respectively). A higher neutrophil-to-lymphocyte ratio was determined in the geriatric group, but the difference was not significant (p=0.176). According to the optimumal cutoff value of 12.11×103/µL for WBC, specificity and sensitivity values of 65.4% and 57.9% were calculated, respectively; the AUC value was 0.632+-0.024 (p<0.001). A receiver operating characteristic (ROC) analysis was used to calculate the optimum cutoff values of neutrophil-to-WBC ratio, lymphocyte, and the mean platelet volume, but the diagnostic accuracy of these tests was inadequate with an AUC of <0.6.[¤]DISCUSSION AND CONCLUSION[|]WBC values >12.11×103/µL were predictive of acute appendicitis in geriatric patients. The other parameters were not predictive, and further studies are required.[¤]https://jag.journalagent.com/z4/download_fulltext.asp?pdir=nci&un=NCI-93457acute appendicitisgeriatric patients; laboratory parameters.
spellingShingle Savaş Bayrak
Cihad Tatar
Ekrem Çakar
Sukru Colak
Mehmet Emin Gunes
Kemal Tekeşin
Bünyamin Gürbulak
Erdem Kinaci
Mert Mahsuni Sevinc
Evaluation of the predictive power of laboratory markers in the diagnosis of acute appendicitis in the elderly
İstanbul Kuzey Klinikleri
acute appendicitis
geriatric patients; laboratory parameters.
title Evaluation of the predictive power of laboratory markers in the diagnosis of acute appendicitis in the elderly
title_full Evaluation of the predictive power of laboratory markers in the diagnosis of acute appendicitis in the elderly
title_fullStr Evaluation of the predictive power of laboratory markers in the diagnosis of acute appendicitis in the elderly
title_full_unstemmed Evaluation of the predictive power of laboratory markers in the diagnosis of acute appendicitis in the elderly
title_short Evaluation of the predictive power of laboratory markers in the diagnosis of acute appendicitis in the elderly
title_sort evaluation of the predictive power of laboratory markers in the diagnosis of acute appendicitis in the elderly
topic acute appendicitis
geriatric patients; laboratory parameters.
url https://jag.journalagent.com/z4/download_fulltext.asp?pdir=nci&un=NCI-93457
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AT ekremcakar evaluationofthepredictivepoweroflaboratorymarkersinthediagnosisofacuteappendicitisintheelderly
AT sukrucolak evaluationofthepredictivepoweroflaboratorymarkersinthediagnosisofacuteappendicitisintheelderly
AT mehmetemingunes evaluationofthepredictivepoweroflaboratorymarkersinthediagnosisofacuteappendicitisintheelderly
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