炎症信号全谱：根据EAES 2015指南对急性阑尾炎各阶段的详细探讨

Inflammatory Signals Across the Spectrum: A Detailed Exploration of Acute Appendicitis Stages According to EAES 2015 Guidelines.

作者信息

Dölling Maximilian, Andric Mihailo, Rahimli Mirhasan, Klös Michael, Pachmann Jonas, Stockheim Jessica, Al-Madhi Sara, Wex Cora, Kahlert Ulf D, Herrmann Martin, Perrakis Aristotelis, Croner Roland S

机构信息

University Clinic for General-, Visceral-, Vascular and Transplantation Surgery, Faculty of Medicine, Otto-Von-Guericke University, 39120 Magdeburg, Germany.

Molecular and Experimental Surgery, Department of General-, Visceral-, Vascular and Transplant Surgery, Faculty of Medicine and University Hospital Magdeburg, Otto-Von-Guericke University, 39120 Magdeburg, Germany.

出版信息

Diagnostics (Basel). 2024 Oct 21;14(20):2335. doi: 10.3390/diagnostics14202335.

DOI:10.3390/diagnostics14202335

PMID:39451658

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11506629/

Abstract

: In this retrospective study, we evaluate the diagnostic utility of C-reactive protein (CRP) and leucocyte count within the EAES 2015 guidelines for acute appendicitis (AA) in differentiating uncomplicated (UAA) from complicated AA (CAA). Conducted at a tertiary care center in Germany, the study included 285 patients over 18 years who were diagnosed with AA from January 2019 to December 2021. Patient data included demographics, inflammatory markers, and postoperative outcomes. CRP levels (Md: 60.2 mg/dL vs. 10.5 mg/dL; < 0.001) and leucocyte count (Md: 14.4 Gpt/L vs. 13.1 Gpt/L; = 0.016) were higher in CAA. CRP had a medium diagnostic value for detecting CAA (AUC = 0.79), with a cutoff at 44.3 mg/L, making it more likely to develop CAA. Leucocyte count showed low predictive value for CAA (AUC = 0.59). CRP ≥ 44.3 mg/L was associated with a higher risk of postoperative complications (OR: 2.9; = 0.002) and prolonged hospitalization (OR: 3.5; < 0.001). CRP, within the context of the EAES classification, presents as a valuable diagnostic marker to distinguish CAA from UAA, with a higher risk of postoperative complications and hospitalization. Leucocyte count showed low diagnostic value for the identification of CAA.

摘要

在这项回顾性研究中，我们评估了C反应蛋白（CRP）和白细胞计数在欧洲急性阑尾炎学会（EAES）2015年急性阑尾炎（AA）指南中对于区分非复杂性急性阑尾炎（UAA）和复杂性急性阑尾炎（CAA）的诊断效用。该研究在德国的一家三级医疗中心进行，纳入了2019年1月至2021年12月期间诊断为AA的285例18岁以上患者。患者数据包括人口统计学信息、炎症标志物和术后结果。CAA患者的CRP水平（中位数：60.2mg/dL vs. 10.5mg/dL；<0.001）和白细胞计数（中位数：14.4Gpt/L vs. 13.1Gpt/L；=0.016）更高。CRP对检测CAA具有中等诊断价值（AUC=0.79），临界值为44.3mg/L，提示更有可能发展为CAA。白细胞计数对CAA的预测价值较低（AUC=0.59）。CRP≥44.3mg/L与术后并发症风险较高（OR：2.9；=0.002）和住院时间延长（OR：3.5；<0.001）相关。在EAES分类背景下，CRP是区分CAA和UAA的有价值诊断标志物，其术后并发症和住院风险更高。白细胞计数对CAA的诊断价值较低。