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. 2024 Nov 5;16(11):e73046.
doi: 10.7759/cureus.73046. eCollection 2024 Nov.

Diagnostic Value of Systemic Immune Inflammation Index in Identifying Complicated Acute Appendicitis Cases

Mehmet Sait Berhuni  1 , Hüseyin Yönder  1 , Hasan Elkan  1 , Muhammed Hamza Koyuncu  1 , Ferhat Özgül  1 , Faik Tatlı  2 , Abdullah Özgönül  1 , Ali Uzunköy  1
Affiliations

Diagnostic Value of Systemic Immune Inflammation Index in Identifying Complicated Acute Appendicitis Cases

Mehmet Sait Berhuni et al. Cureus. .

Abstract

Purpose: Systemic immune inflammation index (SII) has been used to evaluate the prognosis of various diseases in recent years. This study aimed to investigate the efficacy of SII in the preoperative diagnosis of complicated acute appendicitis (CAA).

Materials and method: The data of patients who underwent surgery for acute appendicitis (AA) between January 2021 and December 2023 at our clinic were retrospectively analyzed. These patients had undergone surgical operations for AA and had available pathology results. Cases with histopathologic findings of gangrenous appendicitis, phlegmonous appendicitis, perforated appendicitis, and periappendicular abscesses were considered CAA. Cases without these manifestations and reported as appendicitis upon histopathological analysis were considered as noncomplicated acute appendicitis(NCAA). Data recorded and evaluated for the study included age, sex, preoperative C-reactive protein (CRP) levels, white blood cell (WBC) count, neutrophil count, lymphocyte count, platelet count, neutrophil-to-lymphocyte ratio (NLR), Alvarado score (AS), SII, and histopathologic examination results.

Results: A total of 441 patients were included in the study. The mean age of the patients was 34.58 ± 11.70 years. There were 200 women (45.35%) and 241 men (54.65%). The number of noncomplicated and complicated cases was 332 (75.28%) and 109 (24.72%), respectively. SII, AS, NLR, and CRP values were significantly higher in the complicated group (p < 0.001, p < 0.001, p < 0.001, p = 0.001, respectively). The sensitivity and specificity of SII in detecting CAAs were 0.624 and 0.607, respectively, with a cutoff value of 1445.

Conclusion: The sensitivity of SII in detecting CAA was 0.624, with specificity and cutoff values of 0.607 and 1445, respectively. SII can be used as an effective parameter for preoperatively predicting whether an AA case is complicated or not.

Keywords: acute appendicitis; complicated acute appendicitis; gangrenous appendicitis; perforated appendicitis; phlegmonous appendicitis; systemic immune inflammation index.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Harran University Clinical Research Ethics Committee issued approval 13.05.2024/06. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. ROC curve of biomarkers to predict complicated appendicitis
ROC: Receiver operating characteristic
See this image and copyright information in PMC

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