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The predictive value of Alvarado score, inflammatory parameters and ultrasound imaging in the diagnosis of acute appendicitis   
Yazarlar
Ceren Şen Tanrıkulu
Türkiye
Mehmet Akif Karamercan
Türkiye
Yusuf Tanrıkulu
Türkiye
Dr. Öğr. Üyesi Miraç KOÇ
Kastamonu Üniversitesi, Türkiye
Yücel Yüzbaşıoğlu
Sağlık Bilimleri Üniversitesi, Türkiye
Figen Çoşkun
Dokuz Eylül Üniversitesi, Türkiye
Özet
Objective: Acute appendicitis (AA) is one of the most common surgical emergencies. Despite extraordinary advances in modern investigations, the accurate diagnosis of AA remains an enigmatic challenge. The aim of this study was to compare and evaluate the diagnostic accuracy of inflammatory parameters [C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR)], ultrasound (US) and Alvarado score (AS) in reducing the rate of negative appendectomies. Material and Methods: Two hundred seventy-eight patients were included in this study. Patients were separated into two main groups as the surgery group (n=184) and non-operative group (n=94). Complete blood count, ESR and PCT levels were assessed, abdominal US was performed and AS was calculated for all patients. Results: In the surgery group, clinical predictive factors for histopathologic results such as AS ≥7, AA signs on US, neutrophilia and leukocytosis were significant. Neutrophilia and leukocytosis had the highest accuracy rate among these factors. Inflammatory parameters were not predictive for histopathologic results, although higher CRP and PCT levels were significant in perforated and necrotizing appendicitis. Multifactorial regression analyses showed that AS was not of significant predictive value in the non-operative group. Conclusion: There was no superiority of AS and/or US in the diagnosis of AA. Recent findings have shown the most reliable parameters in the diagnosis of AA to be primarily 'neutrophilia' and secondarily 'leukocytosis'. Other results of this study indicated that inflammatory parameters (CRP, PCT, ESR) were not superior to other parameters but CRP and PCT levels were significantly high in complicated cases.
Anahtar Kelimeler
Acute appendicitis | Alvarado score | C-reactive protein | Ultrasound
Makale Türü Özgün Makale
Makale Alt Türü Ulusal alan endekslerinde (TR Dizin, ULAKBİM) yayımlanan tam makale
Dergi Adı Turkish Journal of Surgery
Dergi ISSN 1300-0705
Dergi Tarandığı Indeksler TR DİZİN
Makale Dili Türkçe
Basım Tarihi 01-2016
Cilt No 32
Doi Numarası 10.5152/UCD.2015.3103
Makale Linki http://dx.doi.org/10.5152/ucd.2015.3103