Diagnostic value of platelet indices in acute appendicitis and comparison with histopathology
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Abstract
BACKGROUND: Acute appendicitis is one of the most common surgical emergencies. An early and accurate diagnosis of acute appendicitis is vital. Evidence for a link between platelets indices and inflammation disease comes from recent studies. We aimed to evaluate preoperative diagnostic values of platelet indices (Mean platelet volume-MPV, Platelet Distribution Width-PDW, Plateletcrit-PCT) and leukocyte count (WBC) in comparison with post-operative histopathology results in patients who underwent appendectomy.
METHODS: The 165 patients who underwent appendectomy, were evaluated retrospectively. Patients’ demographic characteristics, imaging findings, preoperative laboratory markers and postoperative histopathology results were recorded. The patients were divided into three groups based on the histopathologic findings; perforated appendicitis, acute appendicitis without perforation and negative appendectomy group. The specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) of the laboratory markers were measured. Additionally potential correlation among laboratory markers analysed.
RESULTS: The negative appendectomy rate was 15.1% in 165 patients. The leukocyte count was statistically higher in acute appendicitis (14.9×103/μL) group than negative appendectomy (6.9×103/μL) group. There was also statistically significant difference between groups according to the PCT levels. The leukocyte count achieved sensitivity, specificity, PPV, and NPV of 95.9, 24, 99.1, and 92.7% respectively. A significant positive correlation between WBC and PCT were obtained. Inflammatory markers were not directly related to the severity of the disease.
CONCLUSIONS: Elevated leukocyte count and PCT levels support diagnosis of acute appendicitis in correlation with pathological findings. Thereby combination of the inflammatory markers, positive clinical and radiological findings would improve diagnostic accuracy in acute appendicitis.