Ulus Travma Acil Cerrahi Derg. 2023; 29(8): 872-876 | DOI: 10.14744/tjtes.2023.60196

A new, simple marker for predicting complicated appendicitis in patients with normal white blood cell count indicator; LUC %

Erdinc Cetinkaya, Sukru Melih Bayazitli, Abidin Göktaþ, Tezcan Akýn, Ozgur Akgul, Sadettin Er, Enver Okan Hamamcý, Huseyin Berkem, Bülent Cavit Yüksel, Mesut Tez
Department of General Surgery, Ankara Bilkent City Hospital, University of Health Sciences, Ankara-Türkiye

BACKGROUND: The aim of this study was to investigate the ability of a new marker that could be easily obtained to differentiate between complicated and uncomplicated appendicitis in a patients with a white blood cell (WBC) count within the normal range.
METHODS: The patients who underwent surgery with histopathologically proven acute appendicitis (AA) between January 2021 and October 2022 were evaluated retrospectively. Patients were classified into two groups as uncomplicated and complicated appendicitis, based on the surgical and histopathological findings. Groups were compared in terms of laboratory parameters at the time of hospital admission.
RESULTS: During the study period, 2589 patients underwent an appendectomy, among these 612 patients who had a WBC count within the normal range at the time of admission were analyzed. Uncomplicated appendicitis was detected in 79.6% of the patients and complicated appendicitis in 20.4%. Neutrophil%, neutrophil-to-lymphocyte ratio, C-reactive protein, and total bilirubin levels were significantly higher, whereas lymphocyte%, lymphocyte count, lymphocyte-to-monocyte ratio, sodium levels, and large unstained cells (LUC)% were significantly lower in patients with complicated appendicitis. Multiple logistic regression analysis revealed that lower LUC% (Odds Ratio [OR]: 0.45; 95% Confidence Intervals [CI]: 1.08–2.09; P=0.01) and higher total bilirubin levels (OR: 1.50; 95% CI: 1.08–2.09; P=0.01) were independent risk factors for complicated appendicitis.
CONCLUSION: In patients with a diagnosis of AA with a normal WBC value, LUC% obtained from the complete blood count can be used as a new parameter predicting the diagnosis of complicated appendicitis.

Keywords: Acute appendicitis, complicated appendicitis; large unstained cells; predictive biomarkers; LUC.

---

Beyaz küre sayýsý normal olan hastalarda komplike apandisit tanýsý için yeni, basit bir belirteç: LUC %

Erdinc Cetinkaya, Sukru Melih Bayazitli, Abidin Göktaþ, Tezcan Akýn, Ozgur Akgul, Sadettin Er, Enver Okan Hamamcý, Huseyin Berkem, Bülent Cavit Yüksel, Mesut Tez
Saðlýk Bilimleri Üniversitesi, Ankara Bilkent Þehir Hastanesi, Genel Cerrahi Kliniði, Ankara, Türkiye

AMAÇ: Bu çalýþmanýn amacý, beyaz küre sayýsý normal aralýkta olan akut apandisit tanýlý hastalarda, komplike ve komplike olmayan apandisit ayýrýcý tanýsý için kolayca elde edilebilecek yeni bir belirteci araþtýrmaktýr.
GEREÇ VE YÖNTEM: Ocak 2021-Ekim 2022 tarihleri arasýnda histopatolojik olarak kanýtlanmýþ akut apandisit nedeniyle ameliyat edilen hastalar geriye dönük olarak deðerlendirildi. Hastalar cerrahi ve histopatolojik bulgulara göre komplike olmayan ve komplike apandisit olarak iki gruba ayrýldý. Gruplar hastaneye yatýþ anýndaki laboratuvar parametreleri açýsýndan karþýlaþtýrýldý.
BULGULAR: Çalýþma süresi boyunca 2589 hastaya apendektomi yapýlmýþtýr. Bu hastalardan baþvuru anýnda beyaz küre sayýsý normal sýnýrlar içerisinde olan 612 hasta analiz edildi. Hastalarýn %79.6’sýnda komplike olmayan apandisit, %20.4’ünde komplike apandisit saptandý. Komplike apandisit grubundaki hastalarda nötrofil yüzdesi, nötrofil/lenfosit oraný (NLR), C-reaktif protein ve total bilirubin düzeyleri anlamlý olarak daha yüksek, lenfosit yüzdesi, lenfosit sayýsý, lenfosit/monosit oraný (LMR), serum sodyum düzeyi ve LUC yüzdesi anlamlý olarak daha düþük bulundu. Lojistik regresyon analizinde, düþük LUC yüzdesi (OR: 0.45; %95 CI: 1.08-2.09; p=0.01) ve yüksek total bilirubin düzeylerinin (OR: 1.50; %95 CI: 1.08-2.09; p=0.01) komplike apandisit için baðýmsýz risk faktörleri olduðu gösterildi.
SONUÇ: Beyaz küre sayýsýnýn normal olduðu akut apandisit tanýlý hastalarda, tam kan sayýmýndan elde edilen LUC yüzdesi, komplike apandisit tanýsýný öngören yeni bir parametre olarak kullanýlabilir.

Anahtar Kelimeler: Akut appendisit, komplike appendisit; bio belirteçler; LUC.

---

CITE