The Relationship Between Pan-Immune Inflammatory Values in Differentiating Complicated and Non-Complicated Appendicitis

A ÇETİNKAYA¹, AE Kartal², SE Ünlü Ballı³, GB Bahadır⁴, İ Sürer⁴

¹HEALTH SCIENCE UNIVERSITY GULHANE MEDICAL FACULTY
²Department of Pediatric Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Türkiye
³Gulhane Training and Research Hospital, Department of Pediatric Surgery
⁴Department of Pediatric Surgery, Health Sciences University Gulhane Medical Faculty

Purpose: Appendicitis is among the most common causes of emergency abdominal surgery in children. Symptoms may be less apparent, particularly in younger age groups, which can result in delays in diagnosis. Distinguishing between non-complicated and complicated cases becomes increasingly challenging as the child's age decreases. This study was designed with the notion that PIV, regarded as a simple, cost-effective, and functional parameter, could serve as a biomarker for differentiating between non-complicated and complicated appendicitis in children.

Method: All patients admitted to the pediatric surgery clinic for appendicitis between January 2018 and October 2024 were included in the sample, and their files were reviewed retrospectively. Of the patients presenting with acute abdomen (n=2142), a total of 1358 (63.4%) were male, with a mean age of 11.5±3.8 years. The pan-immune inflammatory value (PIV) (neutrophil count x monocyte count x platelet count/lymphocyte count) is a new concept introduced in recent years that indicates the degree of inflammation and immunity. The PIV value was determined using complete blood counts.

Results: The patients were divided into three groups: negative exploration (202, 9.4%), non-complicated (1387, 64.8%), and complicated (553, 25.8%). Complete blood tests of the patients determined the PIV value. There was a statistically significant difference (p<0.001) in PIV values among the three groups. The average age of patients in the complicated group was lower than that of patients in the uncomplicated group (p<0.001). Patients in the complicated group had longer hospital stays compared to the other groups (p<0.001). Patients in the complicated group exhibited a higher PIV value (p<0.001).

Conclusion: The PIV value is a straightforward complete blood count that can be calculated at all health centers. We believe that this value will facilitate the distinction between complicated and non-complicated appendicitis through a simple blood test.

Keywords: Appendicitis, Children, Pan-immune inflammation value

A ÇETİNKAYA¹, AE Kartal², SE Ünlü Ballı³, GB Bahadır⁴, İ Sürer⁴

¹sağlık bilimleri üniversitesi,gülhane tıp fakültesi
²Sağlık Bilimleri Üniversitesi, Gülhane Eğitim ve Araştırma Hastanesi, Çocuk Cerrahisi Kliniği, Ankara
³Gülhane Eğitim ve Araştırma Hastanesi, Çocuk Cerrahisi Kliniği
⁴Department of Pediatric Surgery, Health Sciences University Gulhane Medical Faculty

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