Department of General Surgery, Trakya University Faculty of Medicine, Edirne-Turkey.
Ulus Travma Acil Cerrahi Derg. 2022 Jun;28(6):751-755. doi: 10.14744/tjtes.2021.94580.
The aim of the study was to investigate the clinical variations of Systemic Inflammatory Response Index (SIRI), Systemic Inflammation Index (SII), and Alvarado Score during the COVID-19 pandemic period.
Between March 2019 and March 2021, 161 consecutive patients who had surgery due to acute appendicitis were ret-rospectively recruited from Trakya University in Edirne, Turkey. Group I included patients who had surgery during the COVID-19 pandemic and Group II included patients who had surgery before the COVID-19 pandemic period. A total of 80 patients volunteered for Group I and 81 patients for Group II. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio, and lymphocyte/monocyte ratio were calculated. SII was calculated by the formula: platelet (P) × neutrophil (N)/lymphocyte (L). NLR was calculated by dividing the neutrophil count by the number of lymphocytes. SIRI was defined as follows: SIRI = (neutrophil × monocyte/lymphocyte). The Alvarado score was also calculated by using patient history, clinical examination, and laboratory findings.
There was a significant difference between the two groups in terms of displacing pain, nausea/vomiting, right lower quad-rant tenderness, rebound, hyperthermia, leukocytosis, and total Alvarado score (p<0.001). There was a significant difference between two groups in comparison of C-reactive protein, SIRI, and SII values (p<0.001). Group I patients had higher values of these parameters than Group II.
Based on the results obtained from this study, we conclude that COVID-19 pandemic has caused an increase in patients with acute appendicitis admitted to the hospital. This late diagnosis of acute appendicitis caused more complications during COVID-19 pandemic. Alvarado score, SIRI, and SII can be used as a marker to indicate whether complications of acute appendicitis occurred pre- or post-operatively. Therefore, Alvarado score, SIRI, and SII are directly proportional to the complication of acute appendicitis.
本研究旨在探讨 COVID-19 大流行期间全身性炎症反应指数（SIRI）、全身性炎症指数（SII）和 Alvarado 评分的临床变化。
2019 年 3 月至 2021 年 3 月，从土耳其埃迪尔内的特拉克亚大学回顾性招募了 161 例因急性阑尾炎接受手术的连续患者。第 I 组包括在 COVID-19 大流行期间接受手术的患者，第 II 组包括在 COVID-19 大流行前接受手术的患者。第 I 组有 80 名患者自愿参加，第 II 组有 81 名患者。计算中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值和淋巴细胞/单核细胞比值。SII 计算公式为：血小板（P）×中性粒细胞（N）/淋巴细胞（L）。NLR 通过将中性粒细胞计数除以淋巴细胞计数计算。SIRI 定义如下：SIRI=（中性粒细胞×单核细胞/淋巴细胞）。还通过患者病史、临床检查和实验室发现计算 Alvarado 评分。
两组在转移性疼痛、恶心/呕吐、右下腹压痛、反弹、发热、白细胞增多和总 Alvarado 评分方面存在显著差异（p<0.001）。两组比较 C 反应蛋白、SIRI 和 SII 值存在显著差异（p<0.001）。第 I 组患者的这些参数值高于第 II 组。
根据本研究的结果，我们得出结论，COVID-19 大流行导致更多患有急性阑尾炎的患者住院。COVID-19 大流行期间急性阑尾炎的这种晚期诊断导致更多并发症。Alvarado 评分、SIRI 和 SII 可作为术前或术后是否发生急性阑尾炎并发症的标志物。因此，Alvarado 评分、SIRI 和 SII 与急性阑尾炎的并发症成正比。
