Department of General Surgery, University of Health Sciences, Keçiören Training and Research Hospital, Ankara-Turkey.
Ulus Travma Acil Cerrahi Derg. 2022 Mar;28(3):290-295. doi: 10.14744/tjtes.2021.69670.
The aim of the study was to investigate the predictive value of hyponatremia as a new biochemical marker for the early and accurate preoperative diagnosis of complicated appendicitis in the adult population.
732 patients who were operated for acute appendicitis (AA) and diagnosed as perforation intraoperatively were evaluated retrospectively. Serum sodium, C-reactive protein (CRP), and leukocyte levels of patients with perforated and nonperforated appendicitis were compared.
Perforated appendicitis patients had statistically lower serum Na values (p<0.001). Similarly, patients without perforated appendicitis had higher serum CRP values (p<0.001). In patients diagnosed with perforated AA, the sensitivity of plasma sodium concentration was 63%, and the specificity was 66%. The threshold value of plasma sodium concentration ≤137.5 mEq/L had the best possible sensitivity and specificity.
Hyponatremia is a new marker of perforated appendicitis and therefore, serum sodium level measurement should be considered in patients with a clinical presentation consistent with appendicitis if complications are suspected.
本研究旨在探讨低钠血症作为一种新的生化标志物在预测成人复杂性阑尾炎的早期、准确术前诊断中的价值。
回顾性分析 732 例因急性阑尾炎（AA）而行手术治疗并术中诊断穿孔的患者。比较穿孔性和非穿孔性阑尾炎患者的血清钠、C 反应蛋白（CRP）和白细胞水平。
穿孔性阑尾炎患者的血清 Na 值明显更低（p<0.001）。同样，无穿孔性阑尾炎患者的血清 CRP 值更高（p<0.001）。在诊断为穿孔性 AA 的患者中，血浆钠浓度的灵敏度为 63%，特异性为 66%。血浆钠浓度≤137.5 mEq/L 的截断值具有最佳的灵敏度和特异性。
低钠血症是穿孔性阑尾炎的一个新标志物，因此，对于临床表现符合阑尾炎且怀疑有并发症的患者，应考虑进行血清钠水平测量。
