Shu Xin,Ma Chuncan,Peng Zhiwen,et al.Specific predictive model for complications of acute appendicitis in children:value of systemic inflammatory index I and exploration of potential inflammatory mechanisms[J].Journal of Clinical Pediatric Surgery,,():280-284.[doi:10.3760/cma.j.cn101785-20260106-00006]
Specific predictive model for complications of acute appendicitis in children:value of systemic inflammatory index I and exploration of potential inflammatory mechanisms
- Keywords:
- Child; Acute Appendicitis; Complications; Predictive Model; Systemic Inflammatory Index; Inflammatory Mechanism
- Abstract:
- Objective To construct and validate a predictive model for complications of acute appendicitis in young children (age <3 years) through integrating systemic inflammatory index (SII) with clinical indicators,develop clinical tools and explore the inflammatory mechanism.Methods From June 2020 to September 2024,a retrospective study was conducted for 1109 surgical children (326 cases aged under 3 years).They were divided into two groups of complication (n=210) and non-complication (n=899).Systemic inflammatory index (SII) was calculated and converted into natural logarithm (LnSII).Independent risk factors were screened through Logistic regression.And model efficacy was evaluated by ROC curves for exploring the mechanism of inflammation related indicators.Results The incidence of complications was 30.06% in younger subgroup.It was significantly higher than overall population of 18.94% (P<0.001).Multivariate analysis revealed that age <1 year (OR=3.245),body temperature ≥38.5℃ (OR=2.137),CRP ≥20 mg/L (OR=2.568),neutrophil ratio ≥75% (OR=1.982) and LnSII ≥6.5 (OR=3.872) were independent risk factors (all P<0.05).The model based upon the above indicators demonstrated a significant improvement in AUC=0.965 (95%CI:0.898~0.996) in younger subgroup as compared to a single indicator.The simple scoring scale (0-10 points) had a critical value of ≥6 points with a sensitivity of 83.67% and a specificity of 81.25% and a high-risk group complication rate of 65.71%.Inflammatory mechanism showed that the levels of CD62P,platelet neutrophil aggregates,IL-6 and TNF-α spiked significantly in complication group and were correlated positively with LnSII (r=0.653~0.725,all P<0.001).Conclusions The model integrating LnSII and four clinical indicators has high predictive power.And a simple scoring table may be utilized for rapid preoperative evaluation.SII participates in the occurrence and development of complications through mediating neutrophil platelet interactions.
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Memo
收稿日期:2026-1-6。
基金项目:湖南省自然科学基金区域联合基金(2024JJ7555)
通讯作者:张帆,Email:295297286@qq.com