[Diagnostic value of hemomyelogram for acute appendicitis].

Area of Science:

• Medical diagnostics
• Hematology
• Surgical pathology

Background:

• Acute appendicitis is a common surgical emergency.
• Accurate diagnosis and staging are crucial for effective treatment.
• Routine blood tests are often used to support appendicitis diagnosis.

Purpose of the Study:

• To investigate the correlation between hemogram parameters and acute appendicitis severity.
• To identify the most effective routine blood test marker for diagnosing appendiceal perforation.

Main Methods:

• Analysis of preoperative hemomyelograms from 721 patients undergoing appendectomy (2010-2013).
• Evaluation of hemogram parameters at different appendicitis stages.
• Receiver Operating Characteristic (ROC) curve analysis to determine diagnostic accuracy for perforation.
• Validation of a total lymphocyte count cutoff of 1.83 in a separate cohort of 467 patients.

Main Results:

• The percentage of lymphocytes showed the strongest association with the progression of acute appendicitis.
• Total lymphocyte counts less than or equal to 1.83 were indicative of perforation, demonstrating high sensitivity but low specificity.
• The established cutoff value was confirmed in the validation group.

Conclusions:

• Lymphocyte percentage and total lymphocyte counts serve as valuable diagnostic parameters for staging acute appendicitis.
• Total lymphocyte count < 1.83 is a useful indicator for predicting perforative appendicitis.
• These hemogram findings can assist clinicians in managing appendicitis patients.