Pan Xiaotan,Ling Chunrun,Deng Hongqiang,et al.Correlation between preoperative inflammation indexes with diagnosis and treatment strategy of acute appendicitis in pediatric patients[J].Journal of Clinical Pediatric Surgery,,22():871-875.[doi:10.3760/cma.j.cn101785-202210008-014]
Correlation between preoperative inflammation indexes with diagnosis and treatment strategy of acute appendicitis in pediatric patients
- Keywords:
- Inflammation; Appendicitis; Correlation of Data; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the correlation between preoperative inflammation parameters and severity of acute appendicitis (AA) in children.Methods From January 2017 to April 2021,149 hospitalized AA children undergoing laparoscopic appendectomy were recruited as research subjects.According to the postoperative pathological results,they were assigned into two groups of uncomplicated appendicitis (n=28) and complicated appendicitis (n=121).The latter group included 85 cases of purulent appendicitis and 36 cases of gangrene appendicitis.Univariate analysis was performed for comparing the inter-group differences of baseline profiles and preoperative inflammatory parameters.Binary Logistic regression analysis was performed for determining the independent risk factors of complicated appendicitis.Finally receiver operating characteristic (ROC) curve was plotted for evaluating the diagnostic value of inflammatory parameters for complicated appendicitis.Results In the preoperative uncomplicated appendicitis group and complicated appendicitis group,The number and proportion of fever cases or not was respectively[8 cases (28.6%) and 20 cases (71.4%)]vs.[66 cases (54.5%) and 55 cases (45.5%)],white blood cell count (WBC) (10.95±5.50)vs.(15.81±5.12)×109/L, neutrophil count percentage (NEUT%) (67.49±16.97)vs.(82.84±7.99)%, C-reactive protein (CRP) was (17.77±26.06) vs.(83.84±68.47)mg/L, CRP/ALB (albumin, ALB) were (0.61±1.13) vs.(1.97±1.78), prealbumin (PAB) (189.61±50.91)vs.(152.93±57.92)mg/L,and all above these difference was significant statistical (P<0.05). Preoperative NEUT% (OR=1.096,95%CI:1.027~1.170) and CRP(OR=1.045,95%CI:1.006~1.085) were independent risk factors for complicated appendicitis (P<0.05).The areas under the curve of NRUT% and CRP were 0.801 and 0.839,respectively (P<0.05).The critical preoperative NEUT% and CRP values for complex appendicitis were 77.75% and 28.27 mg/L respectively.The critical CRP value of 28.27mg/L was converted into a binary variable,and the calculated relative risk was 1.659 (95%CI:1.321-2.083).Conclusion Preoperative levels of NEUT% and CRP are valuable for predicting complicated appendicitis in children.When NEUT%≥77.75% or CRP≥28.27 mg/L occurs preoperatively,preoperative diagnosis of complicated appendicitis is more likely in AA children.Surgery should be promptly performed.
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Memo
收稿日期:2022-10-8。
基金项目:广西医疗卫生适宜技术开发与推广应用项目(S2019104)
通讯作者:陈嘉波,Email:cjb1205@163.com