Can the Modified Systemic Inflammation Score Predict Complicated Appendicitis?

Area of Science:

• Surgical diagnostics
• Inflammatory markers
• Gastrointestinal surgery

Background:

• Acute appendicitis is a common surgical emergency.
• Differentiating complicated from uncomplicated appendicitis preoperatively is crucial for treatment planning.
• The modified systemic inflammation score (mSIS) is a potential tool for this differentiation.

Purpose of the Study:

• To evaluate the efficacy of the modified systemic inflammation score (mSIS) in differentiating complicated from uncomplicated acute appendicitis preoperatively.
• To assess the predictive value of mSIS for complicated appendicitis.

Main Methods:

• An observational study included 2,584 adult patients diagnosed with acute appendicitis.
• Patients were categorized into complicated (gangrenous, perforated, phlegmonous, or abscess) and uncomplicated groups based on surgical and pathological findings.
• The modified systemic inflammation score (mSIS) was calculated using albumin levels and the lymphocyte-to-monocyte ratio (LMR).

Main Results:

• The modified systemic inflammation score (mSIS) was 0 in 33.6% of cases and 1-2 in 66.4%.
• A statistically significant difference was observed between mSIS values of 0 and 1-2 (p=0.03).
• mSIS 1-2 demonstrated 85% sensitivity and 42% specificity in predicting complicated appendicitis, with a 1.48 times higher probability.

Conclusions:

• The modified systemic inflammation score (mSIS) can be calculated preoperatively using routine laboratory parameters.
• mSIS is a valuable tool for predicting complicated appendicitis, aiding in preoperative differentiation.
• Simple calculation of mSIS can assist in identifying patients with complicated appendicitis.