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Índices inflamatorios predictores de apendicitis aguda complicada en niños / Inflamatory indexes predictors of complicated acute apendicitis in children
Resumen
Resumen
Introducción: la apendicitis es la principal causa de abdomen agudo quirúrgico en pediatría; el retraso en su diagnóstico implica consecuencias graves.
Objetivo: conocer la utilidad de los índices inflamatorios para predicción de apendicitis aguda complicada (AAC) en niños.
Material y métodos: estudio transversal, analítico, retrolectivo. Incluimos pacientes de 3 a 17 años, con y sin apendicitis aguda (AA), con biometría hemática completa (BHC). Se registró BHC prequirúrgica, hallazgos quirúrgicos y resultado histopatológico; grupo I, AAC; grupo II, apendicitis aguda no complicada (AANC) y grupo III, sin AA; con análisis estratificado por grupo etario.
Resultados: se incluyeron 377 pacientes, edad 9 años (RIC 5-12.5), grupo I, 94; grupo II, 94, y grupo III, 189. El grupo I mostró elevación de los índices neutrófilos/linfocitos (INL), plaquetas/linfocitos (IPL) e inmuno/sistémico (IIS) y menor índice linfocitos/monocitos (ILM). Para AA, se observó en preescolares, INL (sensibilidad [S]: 0.85; especificidad [E]: 0.98), IPL (S: 0.76; E: 0.85), IIS (S: 0.92; E: 0.92); escolares, INL (S: 0.90; E: 0.96), IPL (S: 0.70; E: 0.86), IIS (E: 0.91; S: 0.91); adolescentes, INL (S: 0.85; E: 0.97), IPL (S: 0.26; E: 0.95), IIS (S: 0.86; E: 0.86); en AAC, S y E disminuyeron. INL, IPL, ILM e IIS se asociaron con AA en todas las edades; IPL e IIS en preescolares e ILM en escolares se asociaron con AAC.
Conclusión: INL, IPL, ILM e IIS son predictores de AA en edad pediátrica, así como, IPL e IIS en preescolares e ILM en escolares lo son de AAC.
Abstract
Background: Appendicitis is the main cause of acute surgical abdomen in pediatrics. Delay in the diagnosis implies serious consequences.
Objective: To know the utility of inflammation markers for predicting complicated acute appendicitis (CAA) in children.
Material and methods: Analytical cross-sectional retrolective study. We included patients from 3 to 17 years, with and without acute appendicitis (AA), who had complete blood count (CBC). Presurgical CBC, surgical findings and histopathologic results were recorded; group I, CAA; group II, uncomplicated acute appendicitis (UAA); and group III, without AA, with stratified analysis by age group.
Results: 377 patients were included, 9 years of age (IQR 5-12.5), group I (n = 94), group II (n = 94) and group III (n = 189). Group I showed elevation in the values of Neutrophil/ lymphocyte ratio (NLR), Platelet/lymphocyte ratio (PLR) and Systemic immune inflammation (SII) index and lower levels for the Lymphocyte/monocyte ratio (LMR). For AA, in pre-eschoolers, NLR (sensitivity [S]: 0.85; specificity [E]: 0.98), PLR (S: 0.76; E: 0.85), SII (S: 0.92; E: 0.92) was observed; school children, NLR (S: 0.90; E: 0.96), PLR (S: 0.70: E: 0.86), SII (S: 0.91; E: 0.91); adolescents, NLR (S: 0.85; E: 0.97), PLR (S: 0.26; E: 0.95), SII (S: 0.86; E: 0.86); in CAA, S and E decreased. NLR, PLR, LMR and SII were associated with AA in all ages; PLR and SII in preschoolers, LMR in school children were associated with CAA.
Conclusion: NLR, PLR, LMR and SII are predictors of AA in pediatric age, and for AAC, PLR and SII in preschoolers and LMR in school children.
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Alanis-Rivera B, Zúñiga-Vázquez LA, Silva-Escamilla MC. Hiperbilirrubinemia como factor predictivo de apendicitis perforada. Rev Med Inst Mex Seguro Soc. 2016;54(5):552-61. Disponible en: http://revistamedica.imss.gob.mx/editorial/ index.php/revista_medica/article/view/475/971.
Sakellaris G, Partalis N, Dimopoulou D. Acute appendicitis in preschool age children. Salud(i)Ciencia. 2015;21:284- 93. Disponible en: https://www.siicsalud.com/dato/sic/213/ 126115.pdf.
Almaramhy HH. Acute appendicitis in young children less than 5 years: review article. Ital J Pediatr. 2017;43(1):15. doi: 10.1186/s13052-017-0335-2.
Rebollar-González RC, García-Álvarez J, Trejo-Téllez R. Apendicitis aguda: revisión de la literatura. Rev Hosp Jua Mex. 2009;76(4):210-6.
Pogorelić Z, Rak S, Mrklić I, Jurić I. Prospective validation of Alvarado score and Pediatric Appendicitis Score for the diagnosis of acute appendicitis in children. Pediatr Emerg Care. 2015;31(3):164-8. doi: 10.1097/PEC.0000000000000375.
Rojas-Dotor S, Pérez-Ramos J, Rico-Rosillo MG. Quimiotaxis y enfermedad. Rev Med Inst Mex Seguro Soc. 2009; 47(1):51-6. Disponible en: https://www.redalyc.org/articulo. oa?id=457745512012.
Şahbaz NA, Bat O, Kaya B, Ulukent SC, İlkgül Ö, Özgün MY, et al. The clinical value of leucocyte count and neutrophil percentage in diagnosing uncomplicated (simple) appendicitis and predicting complicated appendicitis. Ulus Travma Acil Cerrahi Derg. 2014;20(6):423-6. doi: 10.5505/tjtes.2014.75044.
Yardımcı S, Uğurlu MÜ, Coşkun M, Attaallah W, Yeğen ŞC. Neutrophil-lymphocyte ratio and mean platelet volume can be a predictor for severity of acute appendicitis. Ulus Travma Acil Cerrahi Derg. 2016;22(2):163-8. doi: 10.5505/tjtes.2015.89346.
Halaseh SA, Kostalas M, Kopec CA, Nimer A. Single-Center Retrospective Analysis of Neutrophil, Monocyte, and Platelet to Lymphocyte Ratios as Predictors of Complicated Appendicitis. Cureus. 2022;14(9):e29177. doi: 10.7759/cureus.29177.
Liu L, Shao Z, Yu H, Zhang W, Wang H, Mei Z. Is the platelet to lymphocyte ratio a promising biomarker to distinguish acute appendicitis? Evidence from a systematic review with meta-analysis. PLoS One. 2020;15(5):e0233470. doi: 10.1371/journal.pone.0233470.
Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014;20(23):6212-22. doi: 10.1158/1078-0432. CCR-14-0442.
Celik B, Nalcacioglu H, Ozcatal M, Altuner Torun Y. Role of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department. Ulus Travma Acil Cerrahi Derg. 2019;25 (3):222-8. doi: 10.5505/tjtes.2018.06709.
Yazici M, Ozkisacik S, Oztan MO, Gürsoy H. Neutrophil/lymphocyte ratio in the diagnosis of childhood appendicitis. Turk J Pediatr. 2010;52(4):400-3.
Begic-Kapetanovic S, Avdagic N, Zaciragic A, Hasic S, Babic N, Hadzimuratovic A. Could the neutrophil-to-lymphocyte ratio serve as a marker in the diagnosis and prediction of acute appendicitis complications in children? Arch Med Sci. 2019;17 (6):1672-8. doi: 10.5114/aoms.2019.87697.
Eun S, Ho IG, Bae GE, Kim H, Koo CM, Kim MK, et al. Neutrophil-to-lymphocyte ratio for the diagnosis of pediatric acute appendicitis: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci. 2021;25(22):7097-107. doi: 10.26355/ eurrev_202111_27263.
De la Cruz-Vallejo RN, Quispe-Zaga E, Nieto-Gutiérrez W. Neutrophilic-lymphocytes and platelet-lymphocytes ratios as predictors for acute perforated appendicitis in children. Bol. Med. Hosp. Infant. Mex. 2021;78(6):557-64. Disponible en: https://www.scielo.org.mx/pdf/bmim/v78n6/1665-1146-bmhim -78-6-557.pdf.
Hajibandeh S, Hajibandeh S, Hobbs N, Mansour M. Neutrophil-to-lymphocyte ratio predicts acute appendicitis and distinguishes between complicated and uncomplicated appendicitis: A systematic review and meta-analysis. Am J Surg. 2020;219(1):154-63. doi: 10.1016/j.amjsurg.2019.04.018.
Ishizuka M, Shimizu T, Kubota K. Neutrophil-to-lymphocyte ratio has a close association with gangrenous appendicitis in patients undergoing appendectomy. Int Surg. 2012;97(4):299- 304. doi: 10.9738/CC161.1
Duman L, Karaibrahimoğlu A, Büyükyavuz Bİ, Savaş MÇ. Diagnostic Value of Monocyte-to-Lymphocyte Ratio Against Other Biomarkers in Children With Appendicitis. Pediatr Emerg Care. 2022;38(2):e739-42. doi: 10.1097/PEC.0000000000002347.
Tuncer AA, Cavus S, Balcioglu A, Silay S, Demiralp I, Calkan E, et al. Can mean platelet volume, Neutrophil-to-Lymphocyte, Lymphocyte-to-Monocyte, Platelet-to-Lymphocyte ratios be favourable predictors for the differential diagnosis of appendicitis? J Pak Med Assoc. 2019;69(5):647-54.
Nissen M, Tröbs RB. The lymphocyte-to-monocyte ratio may distinguish complicated from non-complicated pediatric appendicitis: A retrospective study and literature review. Pediatr Neonatol. 2022;63(2):146-53. doi: 10.1016/j.pedneo.2021.08.018.
Ayeni A, Mahmood F, Mustafa A, Mcleish B, Kulkarni V, Singhal S, et al. Predicting the Severity of Acute Appendicitis in Children Using Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR). Cureus. 2022;14(8):e28619. doi: 10.7759/cureus.28619.
Güngör A, Göktuğ A, Yaradılmış RM, Güneylioğlu MM, Öztürk B, Bodur İ, et al. Utility of the systemic immune-inflammation index to predict serious bacterial infections in infants with fever without a source. Postgrad Med. 2022;134(7):698-702. doi: 10.1080/00325481.2022.2091373.
Aydogan S, Dilli D, Soysal C, Akduman H, Örün UA, Taşar M, et al. Role of systemic immune-inflammatory index in early diagnosis of sepsis in newborns with CHD. Cardiol Young. 2022; 32(11):1826-32. doi: 10.1017/S1047951122001202.
Lagunas-Alvarado M, Mijangos-Huesca FJ, Terán-González JO, Lagunas-Alvarado MG, Martínez-Zavala N, Reyes-Franco I et al. Índice de inmunidad-inflamación sistémica en sepsis. Med Int Méx. 2017;33(3):303-9. Disponible en: https:// www.scielo.org.mx/pdf/mim/v33n3/0186-4866-mim-33-03- 00303.pdf.
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