Saridas Ali, Vural Nafis, Duyan Murat, Guven Hasan Can, Ertas Elif, Cander Basar
Department of Emergency Medicine, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.
School of Medicine, Bulent Ecevit University, Zonguldak, Turkey.
Open Med (Wars). 2024 Jul 25;19(1):20241002. doi: 10.1515/med-2024-1002. eCollection 2024.
Acute appendicitis (AA) is the predominant condition responsible for acute abdominal pain across all age demographics. The purpose of this research is to determine if the hemoglobin, albumin, lymphocyte, and platelet (HALP) and modified HALP (m-HALP) scores differ between complicated and uncomplicated appendicitis in patients diagnosed with AA who have applied to the emergency department (ED). Additionally, this study aims to investigate whether HALP and m-HALP scores are superior to other biomarkers.
The retrospective analysis included adult patients, aged eighteen or older, who were diagnosed with AA, and sought treatment at the ED of a tertiary hospital. Patients were divided into two groups: complicated appendicitis (CA) and uncomplicated appendicitis (UCA). The cut-off in diagnostic value measurements was determined using the receiver operating characteristic analysis.
A total of 436 patients (CA: 126, UCA: 310) were included. Neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-albumin ratio, systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune inflammation value (PIV) were found to have acceptable diagnostic power in CA detection (area under the curve [AUC]: 0.735-0.783). In detecting UCA, HALP and m-HALP were of fair diagnostic power (AUC: 0.64, 0.68, respectively).
In this study, we found that although PIV, SIRI, SII, and NLR had acceptable diagnostic values in distinguishing CA and UCA, HALP and m-HALP had fair diagnostic values.
急性阑尾炎(AA)是所有年龄段急性腹痛的主要病因。本研究的目的是确定在因AA就诊于急诊科(ED)的患者中,复杂型阑尾炎和非复杂型阑尾炎患者的血红蛋白、白蛋白、淋巴细胞和血小板(HALP)及改良HALP(m-HALP)评分是否存在差异。此外,本研究旨在调查HALP和m-HALP评分是否优于其他生物标志物。
回顾性分析纳入了18岁及以上诊断为AA并在三级医院急诊科寻求治疗的成年患者。患者分为两组:复杂型阑尾炎(CA)和非复杂型阑尾炎(UCA)。使用受试者工作特征分析确定诊断价值测量的临界值。
共纳入436例患者(CA组126例,UCA组310例)。中性粒细胞与淋巴细胞比值(NLR)、中性粒细胞与白蛋白比值、全身免疫炎症指数(SII)、全身炎症反应指数(SIRI)和全免疫炎症值(PIV)在CA检测中具有可接受的诊断效能(曲线下面积[AUC]:0.735 - 0.783)。在检测UCA时,HALP和m-HALP具有中等诊断效能(AUC分别为0.64和0.68)。
在本研究中,我们发现尽管PIV、SIRI、SII和NLR在区分CA和UCA方面具有可接受的诊断价值,但HALP和m-HALP具有中等诊断价值。