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Zhang Q, Zhao H, Wang F, Li W, Zhang P. Diagnostic value of laboratory parameters for complicated appendicitis: A two‑center study. Biomed Rep 2024; 20:77. [PMID: 38590948 PMCID: PMC10999898 DOI: 10.3892/br.2024.1765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 02/06/2024] [Indexed: 04/10/2024] Open
Abstract
There are two types of treatment for acute appendicitis (AA): surgery and antibiotic therapy. Some patients with complex appendicitis are treated with surgery; however, for uncomplex appendicitis, most could be treated effectively with antibiotics instead. How to distinguish complex appendicitis from uncomplex appendicitis before surgery is currently unknown. The present study aimed to assess the efficacy of the laboratory parameters to diagnose complicated appendicitis. Data from 1,514 cases with acute appendicitis who were admitted to Beijing Tsinghua Changgung Hospital and Beijing Aerospace General Hospital (both Beijing, China) from January 2016 to September 2021 were retrospectively analyzed. All cases were divided into uncomplicated and complicated appendicitis. Independent variables were analyzed by uni- and multivariate logistic regression analyses. Receiver operating characteristic (ROC) curve analysis was used to identify significant parameters in the multivariate logistic regression analysis. Cut-off values, sensitivity, specificity and accuracy with area under the curve (AUC)>0.600 were considered significant parameters. Significant differences were found in age (P<0.001), body temperature (P<0.001), white blood cell (WBC) count (P<0.001), C-reactive protein (CRP; P<0.001), neutrophil count (P<0.001), neutrophil-to-lymphocyte ratio (NLR, P=0.019), platelet-to-lymphocyte ratio (PLR, P<0.001), platelet count (P<0.001), coefficient of variation (CV) and standard deviation (SD) of red blood cell distribution width (RDW); both P<0.001), mean platelet volume (MPV, P<0.001) and total (P<0.001) and direct bilirubin (P<0.001) between the two groups. CRP, neutrophil count, NLR, PLR, platelet count, RDW-CV, RDW-SD, MPV and direct bilirubin levels were found as the independent variables to diagnose complicated appendicitis. In patients with acute appendicitis, CRP >22.95 mg/l, NLR >5.7, serum direct bilirubin >6.1 mmol/l and RDW-SD>17.7 fl were significantly associated with complicated appendicitis.
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Affiliation(s)
- Qian Zhang
- Department of Gastrointestinal Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, P.R. China
| | - Hongwei Zhao
- Department of Gastrointestinal Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, P.R. China
| | - Fangli Wang
- Department of General Surgery, Aerospace Center Hospital, School of Clinical Medicine, Peking University, Beijing 100039, P.R. China
| | - Wenqiang Li
- Department of General Surgery, Aerospace Center Hospital, School of Clinical Medicine, Peking University, Beijing 100039, P.R. China
| | - Peng Zhang
- Department of Gastrointestinal Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, P.R. China
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Ali E, Embaby A, Arafa SM, Elbana AK, Ghazala M, Ibrahim D. Electroconvulsive therapy improves hematological inflammatory markers in bipolar disorder. Psychopharmacology (Berl) 2024; 241:351-357. [PMID: 37999745 DOI: 10.1007/s00213-023-06491-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Immune dysfunction and inflammation participate in the pathophysiology of bipolar disorder (BD). Abnormal levels of inflammatory markers, namely, red cell distribution width (RDW) and platelet distribution width (PDW), were detected in BD. Electroconvulsive therapy (ECT) for various mental disorders including BD was linked to changes in these inflammatory mediators. Hence, we aimed to assess the impact of ECT on PDW and RDW in patients with BD. METHODS Seventy-two patients aged ≥ 16 were enrolled in the current prospective cohort study over 6 months, diagnosed as BD based on DSM-IV and indicated for ECT and complete blood count (CBC) drawn pre-ECT and after four ECT sessions. RESULTS By the end of the ECT sessions, we noticed a significant elevation in PDW with lowering in RDW levels. However, no significant differences were detected before and after ECT regarding platelet (PLTs) count, mean platelet volume (MPV), and Plateletcrit (PCT). CONCLUSION ECT seems to improve the CBC-derived inflammatory markers (RDW and PDW) subsequently, improving the underlying inflammatory process in BD without disturbing PLT homeostasis which support its anti-inflammatory role in BD.
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Affiliation(s)
- Eman Ali
- Psychiatry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Embaby
- Clinical Hematology Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University, Al-Sharika, Zagazig, 44519, Egypt.
| | - Shaymaa M Arafa
- Psychiatry Department, Faculty of Medicine, Al Azhar University for Girls, Cairo, Egypt
| | - Ahmed Kamal Elbana
- Anatomy Department, Faculty of Medicine, Al Azhar University for Men, Cairo, Egypt
- Basic Medical Sciences Department, Sulaiman AlRajhi University, Al Bukayriyah, Saudi Arabia
| | - Mohamed Ghazala
- Clinical Sciences Department, Sulaiman AlRajhi University, Al Bukayriyah, Saudi Arabia
| | - Doaa Ibrahim
- Psychiatry Department, Faculty of Medicine, Al Azhar University for Girls, Cairo, Egypt
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Latifi M, Rahban H, Pourhosein E, Shostak D, Dehghani S. Association between red blood cell distribution width and the prognosis of brain death in patients with a Glasgow Coma Scale < 6. Sci Rep 2023; 13:14027. [PMID: 37640749 PMCID: PMC10462613 DOI: 10.1038/s41598-023-39836-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 07/31/2023] [Indexed: 08/31/2023] Open
Abstract
Red blood cell distribution width (RDW) has been reported as a meaningful prognostic factor in various diseases. Our study compared patients' RDW levels and prognosis at admission and discharge time. A total of 128 patients 77 patients who suffered brain death (subject group), and 51 patients who were discharged from the hospital (control group) with GCS ≤ 6 were recruited from 60 hospitals for this study. Demographical data and RDW measurements in these patients at admission time and brain death/discharge time were extracted into two groups. 46 (35.9%) patients were females and 82 patients (64.1%) were males with a median age of 36 years old. A significant difference in baseline characteristics of GCS (P < 0.001), RDW at admission time (P < 0.001), and RDW at discharge or brain death time (P < 0.001) were noted between the two groups. In the overall population, RDW at admission time had a median value of 13.75% and was positively correlated with gender (P < 0.04, rs = 0.582) and age (P < 0.023, rs = - 0.201). Initially, there were no significant differences in RDW upon admission. However, upon discharge, although the RDW in the control group was not significant (P < 0. 1), the RDW level at the time of brain death was notably 0.45 fold higher (P = 0.001) compared to the time of admission. The standardized residuals at the two-time points showed an approximately normal distribution. The most effective RDW cut-off in Brain death was determined as 14.55. Based on the findings, using RDW as a prognostic factor has a sensitivity of 0.468 and a specificity of 0.137 in diagnosing brain death. RDW biomarker is a simple and inexpensive laboratory test that may be seen as a valuable perspective for initial patient evaluation. RDW is a powerful marker for the prognosis of brain death in patients with a GCS ≤ 6 at admission time, in order to identify a subset of patients who may require more aggressive management in the trauma center.
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Affiliation(s)
- Marzieh Latifi
- Medical Ethics and Law Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Habib Rahban
- Cardiovascular Research Foundation of Southern California, Beverly Hills, CA, USA
- Southern California Medical Education Consortium, Temecula Valley Hospital, Universal Health System, Temecula, CA, USA
| | - Elahe Pourhosein
- Sina Organ Procurement Unit, Sina Hospital, Tehran University of Medical Sciences, Hassan-Abad Sq. Emam Khomeini St., Tehran, 1136746911, Iran
| | - Daniel Shostak
- Cardiovascular Research Foundation of Southern California, Beverly Hills, CA, USA
- Southern California Medical Education Consortium, Temecula Valley Hospital, Universal Health System, Temecula, CA, USA
| | - Sanaz Dehghani
- Sina Organ Procurement Unit, Sina Hospital, Tehran University of Medical Sciences, Hassan-Abad Sq. Emam Khomeini St., Tehran, 1136746911, Iran.
- Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Oymaci E, Kahramansoy N, Tan S, Aydogan S, Yildirim M. The diagnostic role of preoperative blood tests in complicated appendicitis: A feasible approach to surgical decision. Niger J Clin Pract 2023; 26:1005-1010. [PMID: 37635587 DOI: 10.4103/njcp.njcp_906_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Background An accurate diagnosis and timely surgical intervention have significant importance in noncomplicated appendicitis (NCA) and complicated appendicitis (CA). Therefore, any factor that helps in the prediction of CA also contributes to suitable treatment options. Aim This retrospective study aimed to identify any relationship between acute appendicitis (AA) and preoperative blood test levels and whether these parameters can differentiate between NCA and CA patients. Patients and Methods A database of 201 appendectomies and 100 control healthy patients was analyzed between 2019 and 2022. Patients were divided into three groups: NCA without peritonitis or phlegmonous appendicitis as group 1; CA with perforated, necrotizing appendicitis with peritonitis as group 2; and the healthy control group (CG) as group 3. White blood cell (WBC), platelet distribution width (PDW), mean platelet volume (MPV), red cell distribution width (RDW), creatine kinase (CK), and bilirubin levels were collected from the patients and compared statistically between the groups. Results Age, WBC, and PDW levels were set as predictive in the differential diagnosis of CA as a result of receiver operating characteristic (ROC) analysis. The multivariate analysis demonstrated that age (OR: 1.023; 95% CI: 1.000-1.045; P = 0.04), male sex (OR: 3.718; 95% CI: 1.501-9.213; P = 0.005), WBC levels (OR: 1.000; 95% CI: 1.000-1.000; P = 0.002), and PDW levels (OR: 2.129; 95% CI: 1.301-3.484; P = 0.003) were independently associated with CA. Conclusion Age, higher WBC count, and PDW levels are valuable in differentiating the diagnosis of CA from NCA, and this could be a feasible approach for surgical decisions.
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Affiliation(s)
- E Oymaci
- Department of General Surgery, Health Sciences University, Izmir Bozyaka Education and Research Hospital, Turkey
| | - N Kahramansoy
- Department of General Surgery, Health Sciences University, Izmir Bozyaka Education and Research Hospital, Turkey
| | - S Tan
- Department of General Surgery, Health Sciences University, Izmir Bozyaka Education and Research Hospital, Turkey
| | - S Aydogan
- Department of General Surgery, Health Sciences University, Izmir Bozyaka Education and Research Hospital, Turkey
| | - M Yildirim
- Department of General Surgery, Health Sciences University, Izmir Bozyaka Education and Research Hospital, Turkey
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Karatas T, Selcuk EB, Karatas M, Yildirim A, Bitirim MA, Orman I. Evaluation of the performance of simple laboratory parameters used in the diagnosis of acute appendicitis. Niger J Clin Pract 2023; 26:478-484. [PMID: 37203113 DOI: 10.4103/njcp.njcp_588_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Background Acute appendicitis (AA) is one of the most common emergency surgery. Aim To evaluate the performance of laboratory parameters used in the diagnosis of AA. Subjects and Methods There were two groups. In both groups, leukocyte (WBC), neutrophil, lymphocyte count, neutrophil/lymphocyte ratio (NLR), mean platelet volume (MPV), red cell distribution width (RDW), and platelet distribution width (PDW) values were examined in complete blood count (CBC). In addition, serum bilirubin (total bilirubin and direct bilirubin) values were examined. All laboratory parameters studied were compared to evaluate their diagnostic performance. Results A total of 128 people were in the AA group and 122 people were in the healthy group (control). WBC count, neutrophil count, NLR, total bilirubin, direct bilirubin, and PDW values were significantly higher in the AA group than in the control group (P value <0.05). Lymphocyte counts and MPV values in the AA group were significantly lower than in the control group (P value <0.05). The sensitivity and selectivity of the WBC and neutrophil counts in AA were 95.13%, 89.34%, 94.53%, and 93.44%, respectively. The sensitivity and selectivity of the total bilirubin values were 59.38% and 73.77%, respectively. Area under the ROC curve (AUC) values within 95% confidence interval were over 0.900 for neutrophil count, WBC count, direct bilirubin, NLR, and PDW values. AUC values for total bilirubin, lymphocyte count, RDW, and MPV values were below 0.700. Conclusions Diagnostic performances of the laboratory parameters were determined as follows: neutrophil count > WBC count > direct bilirubin = NLR = PDW > total bilirubin = lymphocyte count = RDW = MPV.
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Affiliation(s)
- T Karatas
- Department of Anatomy, Inonu University Medical Faculty, Turkey
| | - E B Selcuk
- Department of Family Medicine, Inonu University Medical Faculty, Turkey
| | - M Karatas
- Department of Medical History and Ethics, Inonu University Medical Faculty, Turkey
| | - A Yildirim
- General Surgery Clinic, Malatya Training and Research Hospital, Turkey
| | - M A Bitirim
- General Surgery Clinic, Istanbul Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Turkey
| | - I Orman
- Department of Gastroenterology, Inonu University Medical Faculty, Turkey
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Utility of Red Cell Distribution Width (RDW) as a Noninvasive Biomarker for the Diagnosis of Acute Appendicitis: A Systematic Review and Meta-Analysis of 5222 Cases. Diagnostics (Basel) 2022; 12:diagnostics12041011. [PMID: 35454059 PMCID: PMC9032964 DOI: 10.3390/diagnostics12041011] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 12/14/2022] Open
Abstract
Background: Despite great advances in medicine, numerous available laboratory markers, and radiological imaging, the diagnosis of acute appendicitis (AA) in some cases still remains controversial and challenging for clinicians. Because of that, clinicians are still looking for an ideal marker that would be specific to AA. The red blood cell distribution width (RDW) has been recently investigated in several studies as a potential biomarker for AA. The aim of this systematic review and meta-analysis was to systematically summarize and compare all relevant data on RDW as a diagnostic biomarker for AA. Methods: This systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Scientific databases (PubMed, Scopus, Web of Science, and Excerpta Medica database—EMBASE) were systematically searched for relevant comparative studies by two independent researches using keywords ((red cell distribution width) OR rdw) AND (appendicitis). An independent assessment of the methodological quality was performed by two authors using the Downs and Black scale. RevMan 5.4 software was used to perform the meta-analysis. Results: Fifteen studies were included in the final meta-analysis; the majority of the studies was retrospective. Nine studies compared the RDW values between AA and non-AA; four studies compared the same between AA and healthy controls, while two studies compared the RDW values among all three groups. The estimated heterogeneity among the studies for all outcome was statistically significant (I2 = 92−99%, p < 0.00001). The pooling the data demonstrated no statistically significant difference in the RDW values (weighted mean difference (WMD) = 0.03, 95% CI = (−0.46, 0.52), p = 0.91) between AA and healthy controls as well as between AA and non-AA cases (WMD = 0.23, 95%CI = (−0.19, 0.65), p = 0.28). A separate subanalysis was performed to evaluate the utility of this biomarker for the pediatric age group. Pooling the data demonstrated no significant difference among the AA and non-AA groups in terms of the RDW values (WMD = 0.99, 95% CI = (−0.35, 2.33), p = 0.15). Conclusion: The RDW value difference demonstrated no statistically significant difference in AA versus healthy individuals and AA versus non-AA individuals. At the moment, there is no evidence of RDW utility in diagnostic testing of AA. Further research with prospective, multicenter studies and studies targeting special patient groups with a large sample size are needed in this field.
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Akdur G, Bardakcı O, Das M, Akdur O, Beyazit Y. Diagnostic utility of hematological indices in predicting adverse outcomes and severity of acute pancreatitis based on BISAP and modified Glasgow score. ULUS TRAVMA ACIL CER 2022; 28:268-275. [PMID: 35485556 PMCID: PMC10493544 DOI: 10.14744/tjtes.2020.26348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/10/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte-ratio (PLR), and red blood cell distribution width (RDW) are simple indicators of inflammatory status previously established as a severity indicator in distinct disease states. This study aimed to determine the impact of these simple hematologic indices with conventional inflammation markers such as C-reactive pro-tein (CRP) and white blood cells in acute pancreatitis (AP) patients and their relationship with AP risk stratification scores including Bedside Index for Severity of Acute Pancreatitis (BISAP) and modified Glaskow Prognostic score (mGPS) scores. METHODS This retrospective study was performed in the emergency department of Canakkale Onsekiz Mart University. A total of 171 patients (male/female: 68 [39.8%]/103 [60.3%]) with AP and 59 age and gender matched healthy subjects (male/female: 23 [39%]/36[61%]) as controls were enrolled in the present study. The patients were grouped according to severity and adverse outcomes according to BISAP and mGPS and a comparative analysis was performed to compare the NLR, PLR, and RDW between groups. RESULTS The mean NLR values of AP patients and control group were 9.62±6.34 and 2.04±1.08, respectively (p<0.001), while the mean PLR values of AP patients and control group were 221.83±122.43 and 83.30±38.89, respectively (p<0.001). Except from RDW, all the other hematologic indices were found to be elevated (p<0.05 for WBC; NLR, PLR, and CRP) on both mild and severe disease at disease onset. NLR and PLR showed significant predictive ability for estimating serious complications associated with AP. CONCLUSION The present study showed that NLR and PLR is increased in AP. Moreover, peripheral blood NLR and PLR values can predict disease severity and adverse outcomes associated with AP and can be used as an adjunctive marker for estimating disease severity.
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Affiliation(s)
- Gökhan Akdur
- Department of Emergency Medicine, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale-Turkey
| | - Okan Bardakcı
- Department of Emergency Medicine, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale-Turkey
| | - Murat Das
- Department of Emergency Medicine, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale-Turkey
| | - Okhan Akdur
- Department of Emergency Medicine, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale-Turkey
| | - Yavuz Beyazit
- Department of Internal Medicine, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale-Turkey
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Ucar Karabulut K, Erinanc H, Yonar A, Kisinma A, Ucar Y. Correlation of histological diagnosis and laboratory findings in distinguishing acute appendicitis and lymphoid hyperplasia. Ann Surg Treat Res 2022; 103:306-311. [DOI: 10.4174/astr.2022.103.5.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/22/2022] [Accepted: 09/01/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Keziban Ucar Karabulut
- Department of Emergency Medicine, Konya Training and Research Hospital, Baskent University, Konya, Turkey
| | - Hilal Erinanc
- Department of Pathology, Konya Training and Research Hospital, Baskent University, Konya, Turkey
| | - Aynur Yonar
- Department of Statistics, Faculty of Science, Selcuk University, Konya, Turkey
| | - Alpaslan Kisinma
- Department of Emergency Medicine, Konya Training and Research Hospital, Baskent University, Konya, Turkey
| | - Yildiz Ucar
- Department of Pulmonary Disease, Konya Private Meram Akademi Hospital, Konya, Turkey
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Antić J, Jokić R, Bukarica S, Lukić I, Dobrijević D, Rakić G, Pajić M, Trajković V, Milenković M. Predictive Value of Red Blood Cell Distribution Width, Mean Platelet Volume and Platelet Distribution Width in Children with Acute Appendicitis. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8111041. [PMID: 34828754 PMCID: PMC8619955 DOI: 10.3390/children8111041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Acute appendicitis in pediatric patients is one of the most common surgical emergencies, but the early diagnosis still remains challenging. The aim of this study was to determine the predictive value of Red blood cell distribution width (RDW), Mean platelet volume (MPV) and Platelet distribution width (PDW) in children with acute appendicitis. Materials and Methods: This study was a retrospective assessment of laboratory findings (RDW, MPV, PDW) of patients who underwent surgical treatment for acute appendicitis from January 2019 to December 2020. Result: During this period, 223 appendectomies were performed at our Institute. In 107 (43%) cases appendicitis was uncomplicated, while in 116 (46.6%) it was complicated. WBC and RDW/MPV ratio were significant parameters for the diagnosis of acute appendicitis with cut-off values of 12.86 (susceptibility: 66.3%; specificity: 73.2%) and 1.64 (susceptibility: 59.8%; specificity: 71.9%), respectively. WBC and RDW/RBC ratio were independent variables for the diagnosis of complicated appendicitis. The cut-off values were 15.05 for WBC (sensitivity: 60.5%; specificity: 70.7%) and 2.5 for RDW/RBC ratio (sensitivity: 72%; specificity: 52.8%). Conclusions: WBC is an important predictor of appendicitis and complicated appendicitis. RDW, MPV and PDW alone have no diagnostic value in pediatric acute appendicitis or predicting the degree of appendix inflammation. However, the RDW/MPV ratio can be an important predictor of appendix inflammation, with higher values in patients with more severe appendix inflammation. RDW/RBC ratio may be an important predictor of complicated appendicitis.
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Affiliation(s)
- Jelena Antić
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
- Correspondence: ; Tel.: +381-64-129-78-52
| | - Radoica Jokić
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Svetlana Bukarica
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Ivana Lukić
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Dejan Dobrijević
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Goran Rakić
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Miloš Pajić
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Veličko Trajković
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Marina Milenković
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
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10
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Somuncu E, Bozdag E, sarici I, Ozcan A, Ozkan C, Basaran C. The diagnostic role of hemogram parameters in pregnant appendicitis. POLISH JOURNAL OF SURGERY 2021; 94:48-53. [DOI: 10.5604/01.3001.0015.3961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Acute appendicitis is the most frequently encountered non-obstetric disease requiring surgical intervention during pregnancy. Early diagnosis reduces maternal and fetal morbidity / mortality rates.
Aim: This study aims to investigate hemogram parameters in the diagnosis of acute appendicitis in pregnant women.
Material and Methods: A retrospective case-controlled study was conducted in three groups. Thirty-nine pregnant patients with acute appendicitis (Group A), 39 fertile nonpregnant patients with acute appendicitis (Group B), and 39 healthy pregnant women (Group C) were included in the study. WBC, neutrophil count, lymphocyte count, NLR, PLR, MPV and RDW values were compared.
Results: The mean NLR values in group A, group B and group C were 7.39 (1.58–46.6), 5.66 (1–20) and 4.23 (1.54–10.77) respectively, and there was a significant difference in NLR values between the groups (P= 0.002). The mean PLR values in group A, group B and group C were 159.09 (69.1–574), 134.28 (21.5-360) and 120 (68.7–334) and difference was statistically significant (P= 0.019). Cutoff points for WBC count was 14155 106/μL (51,3% sensitivity, 82,1% specificity), for neutrophil count is 10955 106/μL (53,8% sensitivity, 84,6% specificity), for NLR is 9.23 (46,2% sensitivity, 92,3% specificity) and PLR is 157,6 (51,3% sensitivity and 82,1% specificity) NLR had largest area under the curve with 0.667 NLR.
Conclusion: Neutrophil count, WBC and PLR were found to be the most valuable inflammatory parameters however, RDW, Lymphocyte count, and MPV levels are not found valuable markers in terms of sensitivity and specificity in the diagnosis of acute appendicitis in pregnant patients by this study.
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Affiliation(s)
- Erkan Somuncu
- Department of General Surgery, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Emre Bozdag
- Department of General Surgery, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - inanc sarici
- Department of General Surgery, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Adem Ozcan
- Department of General Surgery, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Cenk Ozkan
- Department of General Surgery, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Ceren Basaran
- Department of General Surgery, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
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11
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Maghsoudi LH, Kabir K, Soltanian A, Pak H, Ahmadinejad M, Ahmadi AK. A cross-sectional study on evaluation of complete blood count-associated parameters for the diagnosis of acute appendicitis. Health Sci Rep 2021; 4:e326. [PMID: 34277956 PMCID: PMC8279215 DOI: 10.1002/hsr2.326] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/17/2021] [Accepted: 05/28/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND AIMS Acute appendicitis is one of the common causes of abdominal surgeries, however, the rate of negative appendectomy is as high as 20% as the diagnosis of appendicitis is challenging. The study aimed to evaluate complete blood count (CBC)-associated parameters among positive and negative appendectomy patients and determine their diagnostic importance. METHODS In this cross-sectional study, patients who suspected of acute appendicitis were included. Preoperative blood samples taken from these patients for a complete blood count. Following parameters evaluated from their CBC: white blood cell (WBC), platelet (PLT), mean platelet volume (MPV), neutrophils-to-lymphocytes ratio, platelets-to-lymphocytes ratio, red cell distribution width (RDW), and platelet distribution width (PDW). These parameters analyzed for the positive and negative appendectomy patients using statistical analysis. RESULTS Of 200 patients included in the study, 30 patients (15%) underwent negative appendectomy. The mean neutrophils, WBC, red blood cells, neutrophils-to-lymphocytes, and platelets-to-lymphocytes ratio was significantly high among positive appendectomy patients, (P < .05), whereas MPV to platelet ratio was significantly less in this group. The highest diagnostic power for the diagnosis of appendicitis was of neutrophils-to-lymphocytes ratio with the sensitivity of 83.5% and the specificity of 90%. CONCLUSION The findings of our study indicate that neutrophils-to-lymphocytes ratio alone is not sufficient for preoperative diagnosis of acute appendicitis and other CBC-related parameters did not have good sensitivity and specificity. Further studies are therefore required in this area.
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Affiliation(s)
- Leila Haji Maghsoudi
- Department of Surgery, School of Medicine, Shahid Madani HospitalAlborz University of Medical SciencesKarajIran
| | - Kourosh Kabir
- Department of Community Medicine and Epidemiology, School of Medicine, Social Determinants of Health Research CenterAlborz University of Medical SciencesKarajIran
| | - Ali Soltanian
- Department of Surgery, School of MedicineAlborz University of Medical SciencesKarajIran
| | - Haleh Pak
- Department of Surgery, School of Medicine, Shahid Madani HospitalAlborz University of Medical SciencesKarajIran
| | - Mojtaba Ahmadinejad
- Department of Surgery, School of Medicine, Shahid Madani HospitalAlborz University of Medical SciencesKarajIran
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12
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Dalbaşı E, Akgül ÖL. Are average platelet volume, red cell distribution width and platelet distribution width guiding markers for acute appendicitis treatment options? Int J Clin Pract 2021; 75:e14232. [PMID: 33866650 DOI: 10.1111/ijcp.14232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/26/2021] [Accepted: 04/10/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Acute appendicitis (AA) is the most common cause of surgery performed for the acute abdomen. The standard treatment for AA patients has been appendectomy for more than a century. The use of broad-spectrum antibiotics, the medical treatment option has come to the fore in the treatment of uncomplicated AA. AIM Evaluate whether white blood cell (WBC), platelet count, mean platelet volume (MPV), platelet distribution width (PDW), red cell distribution width (RDW) and C-reactive protein (CRP) values of patients diagnosed with uncomplicated AA clinically, with laboratory tests and radiologically with abdominal computed tomography (CT) could be a marker for choosing medical or surgical treatment. MATERIALS AND METHODS 519 patients aged between 20 and 65 years who were diagnosed with uncomplicated AA by abdominal CT in our centre between January 2016 and January 2019 were retrospectively analysed. The presence of at least one of the criteria of 7 mm or more appendix diameter and oedema or fluid accumulation around the appendix was accepted as uncomplicated AA. After the diagnosis of AA, 223 patients were treated medically, while 296 patients underwent laparoscopic appendectomy. The first group included patients who were treated medically and the second group included patients who underwent laparoscopic appendectomy. RESULTS Group 2 patients had higher mean platelet count (P < .005) and RDW (P = .003) values compared to Group 1 patients, while mean PDW (P < .001) values were lower compared to those of Group 1 patients. The differences between the mean WBC, CRP and MPV values of the groups were not statistically significant (P > .05). CONCLUSIONS Recently, studies supporting antibiotic therapy have been conducted in patients diagnosed with AA. As a result, we think that PDW, RDW, and platelet values in patients diagnosed with uncomplicated AA may be a guide in choosing patients to be treated with surgery or antibiotics.
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Affiliation(s)
- Erkan Dalbaşı
- Memorial Diyarbakır Hospital General Surgery Department, Diyarbakır, Turkey
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13
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García-Amador C, Arteaga Peralta V, de la Plaza Llamas R, Torralba M, Medina Velasco A, Ramia JM. Evaluation of Preoperative Clinical and Serological Determinations in Complicated Acute Appendicitis: A Score for Predicting Complicated Appendicitis. Cir Esp 2021; 99:282-288. [PMID: 32624171 DOI: 10.1016/j.ciresp.2020.05.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/27/2020] [Accepted: 05/30/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND To analyze whether clinical and analytical parameters differ according to histopathology in cases of acute appendicitis (AA). METHODS This is a retrospective, observational study including patients (>14 years of age) admitted for suspicion of AA from 1 April 2014 to 31 July 2016. Histopathology was divided into complicated (including perforated and gangrenous AA) and uncomplicated appendicitis (phlegmonous). Sex, age, temperature of patients on admission to the Emergency Department, symptom duration, preoperative white blood cell (WBC) count, neutrophil percentage, mean platelet volume (MPV), platelet distribution width (PDW), C-reactive protein (CRP) and hospital stay were compared in the two groups. RESULTS Three hundred and thirty-five patients were analyzed, and 284 were included. Appendicitis was uncomplicated in 194 (68.3%) and complicated in 90 (31.7%). Age, symptom duration, neutrophil percentage, CRP and hospital stay were higher in the complicated AA group (P < .05). The mean differences between uncomplicated and complicated AA were: age 13.2 years (95% CI: 8.2-18.2), symptom duration 14.1hours (95% CI: 6.3-21.9), neutrophil percentage 5.0% (95% CI: 3.2-6.8), CRP 73.6mg/l (95% CI: 50.0-97.2) and hospital stay 2.2 days (95% CI: 1.4-3.0), with p<0.05 for all these variables. A model based on the preoperative parameters (age, symptom duration, neutrophil percentage and CRP) was calculated to predict the likelihood of complicated AA. The receiver operating characteristic (ROC) of the model had an area under the curve of 0.80 (95% CI 0.75-0.85). CONCLUSION This model is able to diagnose complicated AA without the need for imaging techniques, although it must be validated with prospective analysis.
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Affiliation(s)
- Cristina García-Amador
- Servicio de Cirugía General, Hospital Universitario de Guadalajara, Guadalajara, España.
| | | | | | - Miguel Torralba
- Servicio de Medicina Interna, Hospital Universitario de Guadalajara, Guadalajara, España
| | - Anibal Medina Velasco
- Servicio de Cirugía General, Hospital Universitario de Guadalajara, Guadalajara, España
| | - José Manuel Ramia
- Servicio de Cirugía General, Hospital Universitario de Guadalajara, Guadalajara, España
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14
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Platelet indices in patients with acute appendicitis: a systematic review with meta-analysis. Updates Surg 2021; 73:1327-1341. [PMID: 33439467 DOI: 10.1007/s13304-020-00928-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/11/2020] [Indexed: 02/07/2023]
Abstract
Correlation between blood inflammatory parameters and acute appendicitis (AA) remains controversial. This meta-analysis aims to evaluate whether platelet (PLT) indices including mean platelet volume (MPV), PLT count, and platelet distribution width (PDW) are associated with AA. Pubmed, Embase, and Cochrane Library databases were searched for observational studies published from inception through April 2020 by two independent investigators. Studies reporting associations between platelet indices and AA were selected for inclusion. Standardized mean difference (SMD) and 95% confidence interval (CI) were estimated for continuous outcomes using a DerSimonian-Laird random-effects model. Of 842 records identified, 17 studies with a total of 6793 subjects met our inclusion criteria. Meta-analysis indicated that compared with those in healthy controls, significant decrease in MPV levels was observed in subjects with AA (SMD - 0.34; 95% CI - 0.56 to - 0.12; P = 0.003). Subgroup analyses represented a significant reduction of MPV levels in patients aged ≥ 30 years and non-complicated/non-perforated AA. Due to the small number of studies and patients included in each subgroup, these subgroup analyses need to be interpreted with caution. However, none of the levels of PLT (SMD - 0.13; 95% CI - 0.28-0.012; P = 0.071) or PDW (SMD 0.30; 95% CI - 0.22-0.83; P = 0.257) was seen decrease or increase in subjects with AA. This meta-analysis indicates a significant decrease in MPV levels in patients with AA, which makes MPV have the potential of serving as a biomarker for AA. The associations of other PLT indices with AA need to be further examined.
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15
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Mutlu NM, Peker TT, Soyal ÖB, Akçaboy ZN, Akçaboy EY, Titiz AP, Çiftçi A, Göğüş N. Red Cell Distribution Width in Diagnosis of Brain Death. Transplant Proc 2019; 51:2189-2191. [PMID: 31371213 DOI: 10.1016/j.transproceed.2019.04.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/10/2019] [Accepted: 04/17/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Red blood cell distribution (RDW) is a hematologic index automatically calculated by blood cell counters. Research about RDW in traumatic brain injury showed positive correlation between high RDW values and mortality, which inspired us to investigate whether RDW could be used as a supportive diagnostic biomarker for diagnosis of brain death. Our hypothesis is that RDW may be useful as a biomarker that supports the diagnosis of brain death. METHODS After approval of the ethics committee, 209 patients who had been diagnosed with brain death between January 2012 and July 2018 were retrospectively reviewed. The RDW values of patients on the days of admission, brain death, and cardiac arrest were recorded. Data were collected from hospital database and patient charts. RESULTS Statistical analysis revealed that the RDW values on the days of brain death and cardiac arrest were significantly higher than on the day of admission. In addition, the RDW values for the cardiac arrest day were significantly higher than on the day of brain death (P < .001). CONCLUSIONS We can say that the increase in RDW, which is reported to be an indicator of mortality for many diseases, can be a supporting biomarker for brain death diagnosis when evaluated concomitantly with clinical diagnostic criteria.
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Affiliation(s)
- Nevzat Mehmet Mutlu
- Department of Anesthesiology and Reanimation - Critical Care, Ankara Numune Education and Research Hospital, Ankara, Turkey.
| | - Tülay Tunçer Peker
- Department of Anesthesiology and Reanimation - Critical Care, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Özlem Balkız Soyal
- Department of Anesthesiology and Reanimation - Critical Care, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Zeynep Nur Akçaboy
- Department of Anesthesiology and Reanimation - Critical Care, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Erkan Yavuz Akçaboy
- Department of Anesthesiology and Reanimation - Algology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Ayşe Pınar Titiz
- Department of Neurology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Ali Çiftçi
- Department of Anesthesiology and Reanimation - Critical Care, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Nermin Göğüş
- Department of Anesthesiology and Reanimation - Critical Care, Ankara Numune Education and Research Hospital, Ankara, Turkey
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Shaveisi-Zadeh F, Madani S, Tarlan M, Mozafari H, Khazaei S, Mozafari S. Role of platelet parameters as a biomarker in diagnosis of acute appendicitis: A retrospective case–controlled study. JOURNAL OF ACUTE DISEASE 2019. [DOI: 10.4103/2221-6189.263708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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17
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Gundogmus İ, Algul A, Karagöz A, Kıyançiçek M. PDW and RDW are new parameters for bipolar episodes and unipolar depression. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1468616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- İbrahim Gundogmus
- Department of Psychiatry, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Ayhan Algul
- Department of Psychiatry, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Abdulkadir Karagöz
- Department of Psychiatry, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Murat Kıyançiçek
- Department of Psychiatry, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
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Tural Hesapcioglu S, Kasak M, Cıtak Kurt AN, Ceylan MF. High monocyte level and low lymphocyte to monocyte ratio in autism spectrum disorders. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2017; 65:73-81. [PMID: 34141326 PMCID: PMC8115457 DOI: 10.1080/20473869.2017.1371369] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Objective: This study aims to investigate the level of peripheral blood mononuclear cells and their ratios which may point to the immunological mechanisms involved in the etiopathogenesis of ASD. Method: The complete blood count parameters of the 45 ASD cases were compared with those of healthy controls.Childhood Autism Rating Scale (CARS) was performed to measure the disease severity. Results: The monocytes of ASD group were significantly higher; and the lymphocyte-to-monocyte ratio (LMR) was lower than the controls'. LMR and neutrophil-to-lymphocyte ratio were found to be predictors of ASD. The decrease in LMR (B: -0.744; P=0.035; CI: -1.431 to -0.056) and the increase in age (B: 0.432; P=0.045; CI: 0.011-0.853) were related to high CARS scores in linear regression analyses. Conclusions: The results of this study support the role of altered immune cell counts and ratios in ASD. A high monocyte level and low LMR may have diagnostic values in autism.
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Affiliation(s)
- Selma Tural Hesapcioglu
- Faculty of Medicine, Child and Adolescent Psychiatry Department, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Meryem Kasak
- Faculty of Medicine, Child and Adolescent Psychiatry Department, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Aysegül Nese Cıtak Kurt
- Faculty of Medicine, Child Neurology Department, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Mehmet Fatih Ceylan
- Faculty of Medicine, Child and Adolescent Psychiatry Department, Ankara Yildirim Beyazit University, Ankara, Turkey
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Arer İM, Yabanoğlu H, Çalışkan K. Can red cell distribution width be used as a predictor of acute cholecystitis? Turk J Surg 2017; 33:76-79. [PMID: 28740954 PMCID: PMC5508246 DOI: 10.5152/turkjsurg.2017.3392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 12/01/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Acute cholecystitis is a common disease requiring accurate markers for diagnosis and proper treatment. The aim of this study was to investigate the role of red cell distribution width (RDW) in acute cholecystitis. MATERIAL AND METHODS 299 were included in the study. The subjects were divided into 2 groups; group 1 (n: 46) acute cholecystitis group and group 2 (n: 253) chronic cholecystitis group. The patients were compared with respect to demographic characteristics, white blood cell count, C-reactive protein, and red cell distribution width. RESULTS A statistically significant difference was observed between groups with respect to gender, white blood cell count, C-reactive protein, and red cell distribution width level (p<0.05). The mean red cell distribution width level of group 1 and 2 was 14.19±2.02% and 15.03±2.51%, respectively. CONCLUSION Red cell distribution width level can be used as a predictor of acute cholecystitis. Multicenter prospective studies should be performed to elucidate the exact role of RDW level in acute cholecystitis.
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Affiliation(s)
- İlker Murat Arer
- Department of General Surgery, Başkent University Adana Application and Research Center, Adana, Turkey
| | - Hakan Yabanoğlu
- Department of General Surgery, Başkent University Adana Application and Research Center, Adana, Turkey
| | - Kenan Çalışkan
- Department of General Surgery, Başkent University Adana Application and Research Center, Adana, Turkey
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20
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Boshnak N, Boshnaq M, Elgohary H. Evaluation of Platelet Indices and Red Cell Distribution Width as New Biomarkers for the Diagnosis of Acute Appendicitis. J INVEST SURG 2017. [PMID: 28635513 DOI: 10.1080/08941939.2017.1284964] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Debate around the value of laboratory tests in establishing the diagnosis of acute appendicitis (AA) still continues. This prospective study aimed to investigate the changes in mean platelet volume (MPV), platelet distribution width (PDW), and red cell distribution width (RDW) with the diagnosis of acute appendicitis. METHOD 200 patients who underwent emergency appendectomy were included. According to postoperative histology, patients were divided into three groups: acute non-complicated, acute complicated appendicitis (positive appendicectomy groups), and negative appendectomy group. White blood cell (WBC), neutrophil, lymphocyte count, neutrophil-to-lymphocyte ratio (NLR), platelets (PLT) count, MPV, PDW, RDW, and C-reactive protein (CRP) were compared among the groups. RESULTS One hundred twenty-five (62.5%) patients had non-complicated acute appendicitis, 20 (10%) had complicated acute appendicitis, while 55 (27.5%) had normal appendix. WBC (p <.001), neutrophil (p <.001), NLR (p <.001), PDW (p =.003), and CRP (p =.001) were higher, while lymphocyte (p <.001) and PLT counts (p =.020) were lower in positive appendectomy compared with negative appendectomy patients. MPV levels were insignificantly different across the groups. RDW level was significantly higher in complicated compared with non-complicated acute appendicitis (p =.006); however, no significant difference was found between positive and negative appendectomy groups. Using receiver operating characteristic analysis, sensitivity, specificity, and diagnostic accuracy respectively were 44.83, 100.0, and 72.415% for WBC count, 72.41, 81.82, and 77.115% for neutrophil count, 48.28, 90.91, and 69.595% for PDW, 89.66, 63.64, and 76.65% for CRP. CONCLUSIONS Increased PDW combined with elevated WBC and neutrophil counts maybe used as diagnostic tests in the cases of acute appendicitis, while MPV and RDW levels were not useful diagnostic markers.
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Affiliation(s)
- Noha Boshnak
- a Department of Clinical Pathology, Faculty of Medicine , Ain Shams University , Cairo , Egypt
| | - Mohamed Boshnaq
- b Department of General Surgery , Queen Elizabeth the Queen Mother Hospital , Margate , Kent , UK.,c Department of General Surgery, Faculty of Medicine , Ain Shams University , Cairo , Egypt
| | - Hatem Elgohary
- d Department of General Surgery, Faculty of Medicine , Helwan University , Cairo , Egypt
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21
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Wise ES, Gadomski SP, Ilg AM, Bermudez C, Chan EW, Izmaylov ML, Gridley SJ, Kaczmarek JV, Melancon NT, Ahmad S, Hocking KM, Diaz JJ, Kavic SM. Independent Preoperative Predictors of Prolonged Length of Stay after Laparoscopic Appendectomy in Patients over 30 Years of Age: Experience from a Single Institution. Am Surg 2016. [DOI: 10.1177/000313481608201124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Prompt discharge after laparoscopic appendectomy (LA) is a marker of quality of care, fiscally desirable and feasible in select patients. Patients over 30 comprise a more heterogeneous cohort known to experience worse outcomes after LA. We aimed to identify easily available preoperative risk factors portending a postoperative length of stay ≥2 days among patients above age 30. In this investigation, 296 included patients from a single institution who underwent LA for acute appendicitis from 2010 to 2014 were retrospectively reviewed for preoperative demographics, laboratory studies, comorbidities, presentation characteristics, radiographic finding, and other rationally selected factors for association with postoperative length of stay ≥2 days. Bivariate and multivariate analysis was conducted to determine independent risk factors, which were subsequently modeled via receiver-operating characteristic curve generation and Kaplan-Meier analysis. “Classic” presentation [odds ratio (OR) = 0.5, P = .02], elevated red cell distribution width (RDW; OR = 1.5/% increase, P = 0.004) as well as evidence of rupture on CT (OR = 6.9, P < 0.001) were independently associated with postoperative length of stay ≥ 2 days. Modeling length of stay using these factors generated an area under the curve of 0.713 ± 0.037. Kaplan-Meier analysis of “classic” presentation, elevated RDW, and evidence of rupture on CT through the fifth postoperative day generated log-rank P values of 0.02, 0.05, and ≤ 0.001, respectively. In summary, lack of “classic” presentation, elevated RDW, and CT evidence of rupture are novel risk factors for prolonged postoperative length of stay in LA patients over 30. These findings may help target patients most appropriate for prompt discharge.
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Affiliation(s)
- Eric S. Wise
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland
| | | | - Annette M. Ilg
- Vanderbilt University School of Medicine, Nashville Tennessee; and
| | - Camilo Bermudez
- Vanderbilt University School of Medicine, Nashville Tennessee; and
| | - Emily W. Chan
- Vanderbilt University School of Medicine, Nashville Tennessee; and
| | | | | | | | | | - Sarwat Ahmad
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland
| | - Kyle M. Hocking
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee
| | - Jose J. Diaz
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland
| | - Stephen M. Kavic
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland
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22
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Bozlu G, Taskinlar H, Unal S, Alakaya M, Nayci A, Kuyucu N. Diagnostic value of red blood cell distribution width in pediatric acute appendicitis. Pediatr Int 2016; 58:202-5. [PMID: 26273790 DOI: 10.1111/ped.12805] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 07/22/2015] [Accepted: 08/10/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the diagnostic value of red blood cell distribution width (RDW) in children with acute appendicitis. METHODS In this retrospective study, a total of 344 children aged ≤18 years with clinically suspected acute appendicitis who underwent appendectomy between January 2007 and January 2014 were reviewed, and 200 healthy controls of the same age group were included. Based on histopathology, the patients were classified as having normal appendix, simple or perforated appendicitis, and preoperative white blood cell count (WBC), C-reactive protein (CRP) and RDW were compared. RESULTS Compared with the controls, mean WBC, CRP and RDW were significantly higher in the appendectomy group (P <0.001). The children with simple or perforated appendicitis had significantly higher WBC, CRP and RDW than did those with normal appendix (P <0.001). Mean WBC and CRP were significantly higher in the children with perforated appendicitis (P <0.001), but no statistically significant difference was found in RDW between the simple and perforated appendicitis groups (P = 0.081). CONCLUSIONS Children with histologically proven acute appendicitis have higher RDW than children without appendicitis, but the diagnostic value of RDW was not superior to WBC or CRP in children with acute appendicitis. Although higher RDW may be valuable for aiding the diagnosis of acute appendicitis in children, it is not a useful marker for predicting perforated appendicitis.
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Affiliation(s)
- Gulcin Bozlu
- Department of Pediatrics, University of Mersin Faculty of Medicine, Mersin, Turkey
| | - Hakan Taskinlar
- Department of Pediatric Surgery, University of Mersin Faculty of Medicine, Mersin, Turkey
| | - Selma Unal
- Department of Pediatrics, University of Mersin Faculty of Medicine, Mersin, Turkey.,Division of Pediatric Hematology, University of Mersin Faculty of Medicine, Mersin, Turkey
| | - Mehmet Alakaya
- Department of Pediatrics, University of Mersin Faculty of Medicine, Mersin, Turkey
| | - Ali Nayci
- Department of Pediatric Surgery, University of Mersin Faculty of Medicine, Mersin, Turkey
| | - Necdet Kuyucu
- Department of Pediatrics, University of Mersin Faculty of Medicine, Mersin, Turkey.,Division of Pediatric Infectious Diseases, University of Mersin Faculty of Medicine, Mersin, Turkey
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Demircan F, Gözel N, Kılınç F, Ulu R, Atmaca M. The Impact of Red Blood Cell Distribution Width and Neutrophil/Lymphocyte Ratio on the Diagnosis of Major Depressive Disorder. Neurol Ther 2015; 5:27-33. [PMID: 26686339 PMCID: PMC4919129 DOI: 10.1007/s40120-015-0039-8] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Indexed: 11/26/2022] Open
Abstract
Introduction Major depressive disorder (MDD) is an important risk factor for cardiovascular mortality and morbidity. Red blood cell distribution width (RDW) and neutrophil/lymphocyte ratio (NLR) can be obtained with a basic hemogram test. These parameters have been found as a predictor of mortality in the general population and in several diseases such as cardiovascular disease. Methods Our study included 100 patients with newly diagnosed MDD and 100 healthy control patients (who had no depressive symptoms and without heart disease) admitted to our outpatient clinics. Patients with MDD were started on selective serotonin reuptake inhibitor (SSRI) treatment and followed up for 3 months. Both MDD and control patients’ laboratory tests and physical, neurological, and psychiatric examinations were performed both at diagnosis and after 3 months of treatment. Results In total, 100 patients with MDD were evaluated and 80 were included in our study. The control group consisted of 91 healthy individuals. The mean age was 44 ± 10.6 years for patients with MDD and 39.8 ± 11.4 years for the control group. There was no significant difference between the age for groups (P = 0.13); 55% of patients with MDD and 33% of the control group was male. NLR levels were found to be 2.55 ± 0.7 and RDW levels were found to be 14.3 ± 2.6 in patients with MDD; NLR levels were found to be 1.41 ± 0.8 and RDW levels were found to be 13.4 ± 1.8 in the control group. RDW and NLR levels were significantly higher in patients with MDD compared to the control group. The significant difference between the levels of RDW and NLR in patients with MDD and the control group was dissolved after SSRI treatment (P < 0.001). RDW [median 14.3, interquartile range (IQR) 2.8 vs. median 13.25, IQR 2.45; P < 0.001] and NLR (median 2.3, IQR 1.1 vs. median 2.0, IQR 1.15; P < 0.001) levels were significantly higher in patients with MDD compared to the control group. Conclusion Our study showed that hematological inflammatory markers might be useful parameters that can be used in patients with MDD for coronary artery disease risk. Specifically, RDW and NLR seem to be more hopeful. Advanced, detailed, and larger studies are needed.
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Affiliation(s)
- Fatih Demircan
- Department of Internal Medicine, Private Etic Life Medical Center, Istanbul, Turkey.
| | - Nevzat Gözel
- Department of Internal Medicine, Firat Medical Faculty, Elazig, Turkey
| | - Faruk Kılınç
- Department of Internal Medicine, Dicle University Medical Faculty, Diyarbakir, Turkey
| | - Ramazan Ulu
- Department of Nephrology, Firat Medical Faculty, Elazig, Turkey
| | - Murat Atmaca
- Department of Psychiatry, Firat Medical Faculty, Elazig, Turkey
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Zhang B, Zhao J. Red blood cell distribution width as a prognostic biomarker for mortality in traumatic brain injury. Int J Clin Exp Med 2015; 8:19172-19175. [PMID: 26770551 PMCID: PMC4694451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 09/18/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Traumatic brain injury (TBI) often cause morbidity and mortality, but it is hard to obtained predictive biomarkers. Red blood cell distribution width (RDW) has been reported as a mortalmarker in cardiovascular disease. But it is unknown whethr RDW is associated with the mortality of TBI patients. The aim of this study is to identify whether RDW is a prognostic biomarker for TBI mortality. METHODS A total of 122 patients with TBI were included retrospectively. Patients were divided into Survival Group and Non-survival Group, RDW was compared between 2 groups. Receiver Operating Curve (ROC) was used to evaluate the mortality predictive performances. RESULTS 122 patients were included, the male-female ratio was 2.59 (88/34) with their median age of 49.5 (17-89) years. 13 (11.93%) of them were divided into Non-survival Group. We observed significant difference in RDW between two groups (P < 0.05). The cut-off level for RDW in TBI was ≥ 12.85, with the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were 65.4%, 95.7%, 69.7%, 82.6%, respectively; and area under the curve was 0.805 (95% confidence interval [CI]: 0.703-0.906). CONCLUSIONS Red cell distribution width is a predictor of mortality in patients with TBI.
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Affiliation(s)
- Biao Zhang
- Department of Critical Care Medicine, Suzhou Integrated Chinese and Western Medicine Hospital Suzhou, Jiangsu, China
| | - Jin Zhao
- Department of Critical Care Medicine, Suzhou Integrated Chinese and Western Medicine Hospital Suzhou, Jiangsu, China
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Yilmaz M, Cimilli G, Saritemur M, Demircan F, Isaoglu U, Kisaoglu A, Emet M. Diagnostic Accuracy of Neutrophil/Lymphocyte Ratio, Red Cell Distribution Width and Platelet Distribution Width in Ovarian Torsion. J OBSTET GYNAECOL 2015; 36:218-22. [DOI: 10.3109/01443615.2015.1049989] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Çetinkaya E, Erdoğan A, Akgül Ö, Çelik C, Tez M. High serum cancer antigen 125 level indicates perforation in acute appendicitis. Am J Emerg Med 2015; 33:1465-7. [PMID: 26233617 DOI: 10.1016/j.ajem.2015.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 07/02/2015] [Accepted: 07/03/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The diagnosis of acute appendicitis is sometimes challenging, and prompt evaluation is required because of the risk of complications if not treated appropriately. AIM We aimed to evaluate whether cancer antigen 125 (CA-125) has diagnositic accuracy and predictor of the severity in acute appendicitis. RESULTS Sixty patients with acute appendicitis were recruited prospectively in this study between May 2014 and March 2015. Blood samples were obtained to measure CA-125 levels before appendectomy. Of the 57 patients, 10 had perforated or gangrenous appendicitis intraoperatively. The CA-125 levels were significantly higher in patients with perforated or gangrenous appendicitis than patients with uncomplicated appendicitis (49.9 vs 10.5 U/mL, P=.000). CONCLUSIONS Cancer antigen 125 levels in patients with highly suspected or confirmed appendicitis could help clinicians determine the severity of the disease.
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Affiliation(s)
- Erdinç Çetinkaya
- General Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey.
| | - Ahmet Erdoğan
- General Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Özgür Akgül
- General Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Canbert Çelik
- General Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Mesut Tez
- General Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey
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Dinc B, Oskay A, Dinc SE, Bas B, Tekin S. New parameter in diagnosis of acute appendicitis: Platelet distribution width. World J Gastroenterol 2015; 21:1821-1826. [PMID: 25684947 PMCID: PMC4323458 DOI: 10.3748/wjg.v21.i6.1821] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 08/24/2014] [Accepted: 10/15/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the diagnostic accuracy of the mean platelet volume and platelet distribution width in acute appendicitis.
METHODS: This retrospective, case-controlled study compared 295 patients with acute appendicitis (Group I), 100 patients with other intra-abdominal infections (Group II), and 100 healthy individuals (Group III) between January 2012 and January 2013. The age, gender, and white blood cell count, neutrophil percentage, mean platelet volume, and platelet distribution width values from blood samples were compared among the groups. Statistical analyses were performed using SPSS for Windows 21.0 software. In addition, the sensitivity, specificity, positive and negative predictive values and likelihood ratios, and diagnostic accuracy were calculated.
RESULTS: The mean ages of patients were 29.9 ± 12.0 years for Group I, 31.5 ± 14.0 years for Group II, and 30.4 ± 13.0 years for Group III. Demographic features such as age and gender were not significantly different among the groups. White blood cell count, neutrophil percentage and platelet distribution width were significantly higher in Group I compared to groups II and III (P < 0.05). Diagnostically, the sensitivity, specificity and diagnostic accuracy were 73.1%, 94.0%, and 78% for white blood cell count, 70.0%, 96.0%, and 76.0% for neutrophil percentage, 29.5%, 49.0%, and 34.0% for mean platelet volume, and 97.1%, 93.0%, and 96.0% for platelet distribution width, respectively. The highest diagnostic accuracy detected was for platelet distribution width between Group I and Group III (P < 0.01).
CONCLUSION: Platelet distribution width analysis can be used for diagnosis of acute appendicitis without requiring additional tests, thus reducing the cost and loss of time.
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Abstract
OBJECTIVE We investigated whether red cell distribution width (RDW) was associated with mortality in patients with acute pancreatitis (AP). DESIGN A cross-sectional study. SETTING Patients with AP were recruited in the emergency department and healthy individuals were recruited in healthcare centre in the First Affiliated Hospital of Zhejiang University. PARTICIPANTS A total of 106 patients with AP and 204 healthy individuals were enrolled. PRIMARY AND SECONDARY OUTCOME MEASURES Haematology and biochemistry results of the first test after admission were collected. The significance of the differences in RDW values among healthy individuals, non-survivors of patients with AP, and survivors of patients with AP was determined using one-way analysis of variance. Patients with AP were divided into three groups according to RDW tertiles. All patients with AP were followed up for at least 3 months. Receiver-operating characteristic (ROC) curve analysis and Kaplan-Meier analysis were used to evaluate RDW values to predict mortality of patients with AP. RESULTS The RDW values were non-survivors of patients with AP>healthy individuals>survivors of patients with AP. Patients with AP with the highest RDW tertiles had the lowest levels of Ca, total protein, albumin, haemoglobin, white and red blood cell count, but the highest mortality. The area under the ROC curve of RDW was 0.846 (95% CI 0.727 to 0.964, p<0.001). With a cut-off value of 14.2 for RDW, sensitivity and specificity of RDW to predict mortality were 75.0% and 89.8%, and Kaplan-Meier analysis showed an increase in probability of death with high RDW values. CONCLUSIONS There is significant association between RDW and mortality of patients with AP.
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Affiliation(s)
- Jinmei Yao
- Department of Laboratory Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Guocai Lv
- Department of Laboratory Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Red Blood cell distribution width: an emerging diagnostic factor of acute appendicitis? World J Emerg Surg 2013; 8:54. [PMID: 24369056 PMCID: PMC3877950 DOI: 10.1186/1749-7922-8-54] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 12/19/2013] [Indexed: 11/30/2022] Open
Abstract
Acute appendicitis is the most common surgical abdominal emergency. Immidiate diagnosis of this disease is crucial, because this condition can lead to appendiceal perforation, potential peritonitis, and even death. We read with great interest the article ‘The role of red cell distribution width (RDW) in the diagnosis of acute appendicitis: a retrospective case-controlled study’ by Narci et al. and wanted to discuss whether RDW alone provide certain information about the inflammatory status of the patient with acute appendicitis.
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