Firinci Binali, Aydin Cetin, Yunluel Dilek, Ibrahim Ahmad, Yigiter Murat, Ahiskalioglu Ali
Department of Pediatric Surgery, Medical Faculty of Ataturk University, 25100 Erzurum, Turkey.
Department of Anesthesiology and Reanimation, Medical Faculty of Ataturk University, 25100 Erzurum, Turkey.
Diagnostics (Basel). 2025 Aug 2;15(15):1942. doi: 10.3390/diagnostics15151942.
: Accurately diagnosing acute appendicitis (AA) in children remains clinically challenging due to overlapping symptoms with other pediatric conditions and limitations in conventional diagnostic tools. The systemic immune-inflammation index (SII) has emerged as a promising biomarker in adult populations; however, its utility in pediatrics is still unclear. This study aimed to evaluate the diagnostic accuracy of SII in distinguishing pediatric acute appendicitis from elective non-inflammatory surgical procedures and to assess its predictive value in identifying complicated cases. : This retrospective, single-center study included 397 pediatric patients (5-15 years), comprising 297 histopathologically confirmed appendicitis cases and 100 controls. Demographic and laboratory data were recorded at admission. Inflammatory indices including SII, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were calculated. ROC curve analysis was performed to evaluate diagnostic performance. : SII values were significantly higher in the appendicitis group (median: 2218.4 vs. 356.3; < 0.001). SII demonstrated excellent diagnostic accuracy for AA (AUROC = 0.95, 95% CI: 0.92-0.97), with 91% sensitivity and 88% specificity at a cut-off > 624. In predicting complicated appendicitis, SII showed moderate discriminative ability (AUROC = 0.66, 95% CI: 0.60-0.73), with 83% sensitivity but limited specificity (43%). : SII is a reliable and easily obtainable biomarker for diagnosing pediatric acute appendicitis and may aid in early detection of complicated cases. Its integration into clinical workflows may enhance diagnostic precision, particularly in resource-limited settings. Age-specific validation studies are warranted to confirm its broader applicability.
由于儿童急性阑尾炎（AA）的症状与其他儿科疾病重叠，以及传统诊断工具存在局限性，准确诊断儿童急性阑尾炎在临床上仍然具有挑战性。全身免疫炎症指数（SII）已成为成人人群中有前景的生物标志物；然而，其在儿科中的效用仍不明确。本研究旨在评估SII在区分儿童急性阑尾炎与择期非炎性外科手术中的诊断准确性，并评估其在识别复杂病例中的预测价值。：这项回顾性单中心研究纳入了397例5至15岁的儿科患者，其中包括297例经组织病理学确诊的阑尾炎病例和100例对照。入院时记录人口统计学和实验室数据。计算包括SII、中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）在内的炎症指标。进行ROC曲线分析以评估诊断性能。：阑尾炎组的SII值显著更高（中位数：2218.4对356.3；<0.001）。SII对AA具有出色的诊断准确性（AUROC = 0.95，95%CI：0.92 - 0.97），在临界值>624时，敏感性为91%，特异性为88%。在预测复杂性阑尾炎方面，SII显示出中等判别能力（AUROC = 0.66，95%CI：0.60 - 0.73），敏感性为83%，但特异性有限（43%）。：SII是诊断儿童急性阑尾炎的可靠且易于获得的生物标志物，可能有助于早期发现复杂病例。将其纳入临床工作流程可能会提高诊断精度，特别是在资源有限的环境中。有必要进行特定年龄的验证研究以确认其更广泛的适用性。
