scholarly journals Mean Platelet Volume/Platelet Count Ratio as a Diagnostic Marker in Children with Acute Appendicitis

2021 ◽  
Author(s):  
İnanç Karakoyun ◽  
Mustafa Onur Öztan
Keyword(s):  
Platelet Count ◽  
Acute Appendicitis ◽  
Mean Platelet Volume ◽  
Diagnostic Value ◽  
Complicated Appendicitis ◽  
C Reactive Protein ◽  
Platelet Volume ◽  
Reactive Protein ◽  
Uncomplicated Appendicitis ◽  
Wbc Count

Objective: The objective of this research was to evaluate the diagnostic value of mean platelet volume/platelet count (MPV/PC) ratio in pediatric acute appendicitis. Methods: This retrospective study included a total of 310 patients, 176 in the uncomplicated appendicitis group, 80 in the complicated appendicitis group, and 54 in the nonspecific abdominal pain (NSAP) group. C-reactive protein (CRP) level, white blood cell (WBC) count, absolute neutrophil count (ANC), MPV, PC, and MPV/PC ratio were compared between the groups. Results: WBC and ANC levels differed significantly between the groups (P<0.001 in all pairwise comparisons). CRP levels in the complicated appendicitis group were higher than in the NSAP and uncomplicated appendicitis groups (P<0.001 for both comparisons). There was a negative correlation between MPV and PC (r= -0.434, P<0.001). Both PC and MPV/PC ratio were able to distinguish cases of complicated appendicitis from NSAP (P=0.047 and P=0.045, respectively) and from cases of uncomplicated appendicitis (P=0.010 and P=0.045, respectively). Areas under the ROC curve for CRP, WBC, ANC, MPV, PC, and MPV/PC ratio were 0.640, 0.690, 0.727, 0.553, 0.541, and 0.546, respectively. Conclusion: According to the results of our study, MPV/PC ratio can be used in addition to the conventional markers to discriminate cases of complicated appendicitis.

scholarly journals Role of Monocyte-to-lymphocyte Ratio, Mean Platelet Volume-to-Platelet Count Ratio, C-Reactive Protein and Erythrocyte Sedimentation Rate as Predictor of Severity in Secondary Traumatic Brain Injury: A Literature Review

2021 ◽  
Vol 9 (F) ◽  
pp. 574-583
Author(s):  
Tjokorda Istri Sri Dalem Natakusuma ◽  
Tjokorda Gde Bagus Mahadewa ◽  
Putu Eka Mardhika ◽  
Sri Maliawan ◽  
Tjokorda Gde Agung Senapathi ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Platelet Count ◽  
Brain Injury ◽  
Literature Review ◽  
Sedimentation Rate ◽  
Mean Platelet Volume ◽  
C Reactive Protein ◽  
Platelet Volume ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation

BACKGROUND: Secondary traumatic brain injury (TBI) is injury to the brain following primary TBI because of neuroinflammation as consequences of neuronal and glial cell injury which cause release of various inflammation cytokine and chemokine. Biomarker examination to predict the severity of secondary TBI is important to provide appropriate treatment to the patient. This article reviews possibility several common laboratory parameter such as monocyte-to-lymphocyte ratio (MLR), mean platelet volume-to-platelet count (PC) ratio (MPV-PCR), c-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) to predict severity of secondary TBI. LITERATURE REVIEW: TBI activates microglia which increase infiltration and proliferation of monocyte. Neuroinflammation also increases thrombopoiesis which leads to increase megakaryocytes production. In the other hand, due to disruption of brain blood vessels because of trauma, coagulation cascade is also activated and leads to consumptive coagulopathy. These are reflected as high monocyte count, low PC, and high MPV. Lymphocyte count is reported low in TBI especially in poor outcome patients. CRP is an acute phase reactant that increased in inflammation condition. In TBI, increased production of Interleukin-6 leads to increase CRP production. In head injured patients, ESR level does not increase significantly in the acute phase of inflammation but last longer when compared to CRP. CONCLUSION: MLR, MPV-PCR, CRP, and ESR could be predictor of severity in secondary TBI.

scholarly journals Inferior performance of established and novel serum inflammatory markers in diagnosing periprosthetic joint infections

2020 ◽  
Author(s):  
Irene Katharina Sigmund ◽  
Johannes Holinka ◽  
Kevin Staats ◽  
Florian Sevelda ◽  
Richard Lass ◽  
...  
Keyword(s):  
Platelet Count ◽  
Inflammatory Markers ◽  
Volume Ratio ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Platelet Volume ◽  
Reactive Protein ◽  
Joint Infections ◽  
Serum Crp ◽  
Serum Inflammatory Markers

Abstract Purpose Besides other diagnostic test methods, established serum inflammatory markers such as serum C-reactive protein or leukocyte count are widely used preoperatively to aid in diagnosing periprosthetic joint infections (PJI). Although low accuracies were reported, these parameters are easily accessible and routinely available. Novel biomarkers with promising results in diagnosing PJI (platelet count to mean platelet volume ratio) or other infectious conditions (percentage of neutrophils, neutrophils to lymphocytes ratio) were described. The purpose of this study was to investigate the diagnostic value of established and novel serum inflammatory biomarkers for the diagnosis of PJI so as to compare the results to find the serum inflammatory marker with the best performance. Methods In 177 patients with a previous total hip (n = 91) or knee (n = 86) arthroplasty and indicated revision surgery, the diagnostic value of the routinely available serum inflammatory markers C-reactive protein (CRP), white blood cell count (WBC), percentage of neutrophils (%N), neutrophils to lymphocytes ratio (NLR), fibrinogen and platelet count to mean platelet volume ratio (PC/mPV) were examined retrospectively via receiver operating characteristic curve analysis (AUC). The curves were compared using the z-test. Results Sensitivities of serum CRP, WBC, %N, NLR, fibrinogen and PC/mPV were calculated with 68%, 36%, 66%, 63%, 69% and 43%, respectively. Specificities were 87%, 89%, 67%, 73%, 89% and 81%, respectively. Serum CRP (0.78) and fibrinogen (0.79) showed significantly better AUCs compared with serum WBC (0.63), %N (0.67), NLR (0.68) and PC/mPV (0.62) (p < 0.0001). Patients with PJI caused by a low-virulent microorganism (median CRP: 17.6 mg/L) obtained lower CRP levels compared with infections caused by high-virulent microorganisms (median CRP: 49.2 mg/L; p = 0.044). The combination of CRP and fibrinogen showed a better sensitivity (77%) with similar specificity (83%) than one method alone but not at a significant level (CRP (p = 0.200); fibrinogen (p = 0.437)). Conclusion Serum CRP and fibrinogen showed the best accuracies among these widely available serum inflammatory parameters. However, due to the insufficient performance, these biomarkers can only be recommended as suggestive criteria in diagnosing PJI. The preoperative workup should always be complemented by more specific tests such as synovial fluid analysis.

scholarly journals Perforation rate after a diagnosis of uncomplicated appendicitis on CT

BJS Open ◽  
2021 ◽  
Vol 5 (1) ◽  
Author(s):  
K Lastunen ◽  
A Leppäniemi ◽  
P Mentula
Keyword(s):  
Acute Appendicitis ◽  
Emergency Operation ◽  
Patient Characteristics ◽  
Complicated Appendicitis ◽  
C Reactive Protein ◽  
Perforation Rate ◽  
Reactive Protein ◽  
Hourly Rate ◽  
Uncomplicated Appendicitis ◽  
Uncomplicated Acute Appendicitis

Abstract Background Appendicectomy is a common emergency operation. The aim of this analysis was to study the effect of preoperative delay on disease progression, and whether a novel scoring system (Atema score) could be useful in predicting complicated appendicitis. Methods Patients with uncomplicated acute appendicitis on CT and who underwent appendicectomy in 2014–2015 were analysed for patient characteristics, preoperative delay and outcomes. Results Of 837 patients with uncomplicated appendicitis on CT, 187 (22.3 per cent) were found to have complicated appendicitis at surgery. The median time estimate for perforation was 25.4 h after CT, with an hourly rate of perforation of 2 per cent. Patients with an Atema score of 6 or less and those with no appendicolith on CT and a C-reactive protein level below 51 mg/l were the slowest to develop perforation, reaching a perforation rate of 5 per cent in 7.1 and 7.6 h respectively. Conclusion A substantial proportion of patients with uncomplicated acute appendicitis on CT have complicated appendicitis at surgery. However, in patients with no risk factors, surgery can be postponed safely for up to 7 h.

scholarly journals Predictive values of Alvarado score, serum C-reactive protein, and white blood cell count in the diagnosis of acute appendicitis: a prospective study

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Ademola Olusegun Talabi ◽  
Tewogbade Adeoye Adedeji ◽  
Oludayo Adedapo Sowande ◽  
Olusanya Adejuyigbe
Keyword(s):  
Acute Appendicitis ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
C Reactive Protein ◽  
Blood Cell Count ◽  
Alvarado Score ◽  
Reactive Protein ◽  
Wbc Count

Abstract Background The diagnosis of acute appendicitis in children is quite challenging as the rate of negative appendectomy varies between 15 and 57%. Increased utilization of imaging diagnostic facilities in advanced countries seems to have reduced the incidence of operating on normal appendix to a single digit. In low- and middle-income countries, the incidence remains unacceptably high (double digits). Inflammatory markers and scoring systems may be a suitable adjunct to increase diagnostic yield in most third world countries. Thus, the aim of this study was to evaluate the diagnostic value of Alvarado score, white blood cell count, and serum C-reactive protein in children with acute appendicitis. Results The ages of patients ranged between 4 and 15 years with a mean of 11.2 ± 2.8 years. The male to female ratio was 1.4 to 1.0. Nineteen percent of patients had negative appendiceal findings on histological examination. The sensitivity and specificity of Alvarado score, C-reactive protein estimation, total white blood cell count in diagnosing acute appendicitis were 86.4% and 63.2%, 98.8% and 36.8%, and 51.9% and 89.5% respectively. Alvarado score has the highest area under ROC curve analysis 0.824, 95% CI of 0.724 to 0.924 compared with CRP, 0.769. 95% CI of = 0.647 to 0.891 and WBC count, 0.765, 95% CI of 0.643 to 0.887. Both CRP and WBC count showed higher discriminatory values between complicated and uncomplicated appendicitis, p < 0.001. Conclusion Alvarado score outperformed other tests in setting the diagnosis of acute appendicitis. However, none of the tests can be relied on wholly for operative decision. Clinical judgement remains the bedrock for diagnosis and operative management.

scholarly journals The diagnostic value of white cell count, C-reactive protein and bilirubin in acute appendicitis and its complications

2013 ◽  
Vol 95 (3) ◽  
pp. 215-221 ◽  
Author(s):  
I G Panagiotopoulou ◽  
D Parashar ◽  
R Lin ◽  
S Antonowicz ◽  
AD Wells ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Cell Count ◽  
Inflammatory Markers ◽  
White Cell Count ◽  
Perforated Appendicitis ◽  
Diagnostic Value ◽  
White Cell ◽  
C Reactive Protein ◽  
Reactive Protein

Introduction Inflammatory markers such as white cell count (WCC) and C-reactive protein (CRP) and, more recently, bilirubin have been used as adjuncts in the diagnosis of appendicitis. The aim of this study was to determine the diagnostic accuracy of the above markers in acute and perforated appendicitis as well as their value in excluding the condition. Methods A retrospective analysis of 1,169 appendicectomies was performed. Patients were grouped according to histological examination of appendicectomy specimens (normal appendix = NA, acute appendicitis = AA, perforated appendicitis = PA) and preoperative laboratory test results were correlated. Receiver operating characteristic (ROC) curve area analysis (area under the curve [AUC]) was performed to examine diagnostic accuracy. Results ROC analysis of all laboratory variables showed that no independent variable was diagnostic for AA. Good diagnostic accuracy was seen for AA when all variables were combined (WCC/CRP/bilirubin combined AUC: 0.8173). In PA, the median CRP level was significantly higher than that of AA (158mg/l vs 30mg, p<0.0001). CRP also showed the highest sensitivity (100%) and negative predictive value (100%) for PA. CRP had the highest diagnostic accuracy in PA (AUC: 0.9322) and this was increased when it was combined with WCC (AUC: 0.9388). Bilirubin added no diagnostic value in PA. Normal levels of WCC, CRP and bilirubin could not rule out appendicitis. Conclusions CRP provides the highest diagnostic accuracy for PA. Bilirubin did not provide any discriminatory value for AA and its complications. Normal inflammatory markers cannot exclude appendicitis, which remains a clinical diagnosis.

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