Mean Platelet Volume as an Emerging Biomarker for Diagnosing Acute Appendicitis: A Retrospective Study

Introduction Acute appendicitis is a common surgical emergency that requires a timely and accurate diagnosis to prevent complications. Several laboratory markers have been assessed to improve the diagnostic accuracy of acute appendicitis, including C-reactive protein (CRP), white blood cell (WBC) count, and cytokines like interleukins and tumor necrosis factor-alpha. One less commonly used but potentially valuable marker is the mean platelet volume (MPV), which indicates the size of circulating platelets and has the potential to serve as a biomarker for inflammatory conditions. Methodology The study was designed as a retrospective analytical investigation to examine the role of MPV in diagnosing acute appendicitis. The retrospective design allowed the utilization of existing hospital data, ensuring that sufficient cases of acute appendicitis could be assessed without additional data collection. The calculation was based on statistical parameters, including the standard deviations from previous studies, critical values at a 5% significance level, and an 80% test power, arriving at a minimum required sample size of approximately 100 to ensure adequate statistical power for meaningful conclusions. Results The study found that patients with acute appendicitis had significantly higher MPV compared to the normal reference value of 8.9 fL. The average MPV in the patient group was 10.25 fL, which was statistically higher than the reference value (P < 0.001). Furthermore, the study revealed that MPV levels were even higher in patients with more severe forms of appendicitis, such as perforated or gangrenous appendicitis. The average MPV for the inflamed appendicitis group was 10.13 fL, while the average MPV for the perforated or gangrenous group was 11.26 fL, a statistically significant difference (P < 0.001). Conclusions The study demonstrates that MPV is a potentially valuable marker for diagnosing acute appendicitis and assessing its severity, particularly when used in combination with other biomarkers like neutrophil-to-lymphocyte ratio (NLR) and WBC count.  Elevated MPV in complicated cases of appendicitis, such as perforated or gangrenous appendicitis, suggests that MPV may aid in identifying high-risk patients who require urgent surgical intervention.  While MPV alone may not be as reliable as NLR in predicting appendicitis severity, its inclusion in a multi-biomarker approach could improve clinical decision-making.