The Role of Basic Laboratory Parameters in Diagnosing Acute Appendicitis and Determining Disease Severity in the Elderly

• Published in: Turkish journal of colorectal disease Vol. 32; no. 2; pp. 110 - 116
• Main Authors: Yeni, Mustafa, Peksöz, Rıfat
• Format: Journal Article
• Language: English
• Published: Mersin Galenos Publishing House 01-06-2022
• Subjects: Appendectomy; Appendicitis; Laboratories
• ISSN: 2536-4898; 2536-4901
• DOI: 10.4274/tjcd.galenos.2021.2021-6-3

Aim: Acute appendicitis (AA) is the most common cause of acute abdomen in elderly patients. The aim was to investigate the role of basic laboratory parameters in diagnosing AA and determining disease severity. Method: Elderly patients aged over 65 years who underwent appendectomy were included. The patients were divided into groups according to the severity of AA: group 1 (negative appendectomy) and group 2 (AA). Group 2 was sub-divided into group 2a: uncomplicated appendicitis and group 2b: complicated appendicitis. Differences in basic laboratory parameters between the groups were evaluated statistically. Results: One hundred and forty three elderly patients were examined. Sixty (41.95%) were male and the mean age of the whole cohort was 69.69±6.34 years (range: 65-104 years). Patient numbers in the groups were: group 1 (n=15) (10.5%); group 2a (n=79) (55.2%) and group 2b n=49 (34.3%). As the time of admission to the hospital increases, the severity of the disease increases (p<0.001). Group 2b had higher length of stay (p=0.007) and complication rates (p=0.042). When comparing group 1 with group 2, the most sensitive test (88%) was mean platelet volume, while the most specific test was bilirubin (85%). For distinguishing group 2a and group 2b, the most sensitive test (72%) was C-reactive protein (CRP) while the most specific test (82%) was platelet to lymphocyte ratio (PLR). Conclusion: Preoperative laboratory parameters can be used as biomarkers to aid AA diagnosis in the elderly. Neutrophil to lymphocyte ration, PLR, red cell distribution width, CRP, and direct and total bilirubin levels may help identify complications in appendicitis.