Birben Birkan, Akkurt Gökhan, Akın Tezcan, Surel Aziz A, Tez Mesut
General Surgery, Ankara City Hospital, Ankara, TUR.
Cureus. 2021 Apr 29;13(4):e14748. doi: 10.7759/cureus.14748.
Background The delta neutrophil index has been accepted as an inflammatory marker, especially in sepsis. This study aimed to evaluate the effectiveness of the delta neutrophil index in predicting acute and complicated appendicitis. Methods Patients aged 18 years and over who underwent appendectomy were reviewed. The demographic features, pathology results, and the delta neutrophil index, leukocyte, and C-reactive protein levels were evaluated. According to the pathology results, the patients were grouped as those having a normal appendix or acute appendicitis. Results In this study, 74 (8.1%) of the patients had a normal appendix, and 718 (86.1%) were diagnosed with simple appendicitis, and 116 (13.9%) with complicated appendicitis. In the acute appendicitis group, the leukocyte value and delta neutrophil index were found to be statistically significantly higher than in the normal appendix group. Age, C-reactive protein, and the delta neutrophil index were statistically significantly higher in the complicated appendicitis group. In the receiver operating characteristic curve analysis for the prediction of acute appendicitis, the area under the curve values for leukocyte and the delta neutrophil index were calculated as 0.780 and 0.741, respectively. In predicting complicated appendicitis, the area under the curve of the delta neutrophil index and C-reactive protein were 0.671 and 0.709, respectively. Conclusion The delta neutrophil index was more significant than leukocyte values in diagnosing acute and complicated appendicitis. We consider that the delta neutrophil index is an effective and reliable parameter in diagnosing acute appendicitis and differentiating simple/complicated appendicitis, especially when combined with the analysis of leukocyte and C-reactive protein.
背景 中性粒细胞变化指数已被公认为一种炎症标志物，尤其是在脓毒症中。本研究旨在评估中性粒细胞变化指数在预测急性和复杂性阑尾炎方面的有效性。方法 对接受阑尾切除术的18岁及以上患者进行回顾性研究。评估患者的人口统计学特征、病理结果以及中性粒细胞变化指数、白细胞和C反应蛋白水平。根据病理结果，将患者分为阑尾正常组或急性阑尾炎组。结果 在本研究中，74例（8.1%）患者阑尾正常，718例（86.1%）被诊断为单纯性阑尾炎，116例（13.9%）为复杂性阑尾炎。在急性阑尾炎组中，白细胞值和中性粒细胞变化指数在统计学上显著高于阑尾正常组。复杂性阑尾炎组的年龄、C反应蛋白和中性粒细胞变化指数在统计学上显著更高。在预测急性阑尾炎的受试者工作特征曲线分析中，白细胞和中性粒细胞变化指数的曲线下面积值分别计算为0.780和0.741。在预测复杂性阑尾炎时，中性粒细胞变化指数和C反应蛋白的曲线下面积分别为0.671和0.709。结论 在诊断急性和复杂性阑尾炎方面，中性粒细胞变化指数比白细胞值更具意义。我们认为中性粒细胞变化指数是诊断急性阑尾炎以及区分单纯性/复杂性阑尾炎的有效且可靠的参数，尤其是与白细胞和C反应蛋白分析相结合时。
