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Diagnostic value of hematological parameters in the early diagnosis of acute cholecystitis
Nedim Uzun1, Ozgecan Gundogar2, Naile Misirlioglu3
1Emergency Department, University of Health Sciences Hamidiye Faculty of Medicine, İstanbul, 34250, Turkey.
Insights
The systemic inflammation response index (SIRI) and neutrophil count effectively aid in diagnosing acute cholecystitis (AC). These markers improve diagnostic accuracy, guiding timely treatment for better patient outcomes.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Hematology
Background:
- Accurate diagnosis of acute cholecystitis (AC) is crucial for effective management.
- Early laparoscopic cholecystectomy reduces AC complications and mortality.
- Inflammatory indices and hematological markers are potential diagnostic tools.
Purpose of the Study:
- To evaluate the predictive value of inflammatory indices and hematological markers in diagnosing AC.
- To assess the utility of neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI).
Main Methods:
- Retrospective review of 249 early laparoscopic cholecystectomy cases (August 2013-August 2023).
- Analysis of patient demographics, preoperative laboratory values, and inflammatory indices.
- Evaluation of hospital length of stay and histopathological outcomes.
Main Results:
- 34 patients (13.6%) were diagnosed with AC.
- Significant elevations in SIRI and neutrophil count observed in AC cases (P < 0.001).
- SIRI and neutrophil count showed comparable diagnostic performance (AUC = 0.746) in predicting AC.
Conclusions:
- SIRI and neutrophil count are reliable markers for AC diagnosis.
- These markers can enhance diagnostic accuracy.
- Utilizing SIRI and neutrophil count can guide early management of AC.
Objectives:
Accurate diagnosis of acute cholecystitis (AC) is critical because early laparoscopic cholecystectomy significantly reduces complications and mortality. This study evaluates the predictive value of inflammatory indices and hematological markers in diagnosing AC.
Methods:
A retrospective review was performed on early laparoscopic cholecystectomy cases at the Gaziosmanpaşa Training and Research Hospital in Istanbul between August 2013 and August 2023. Patient demographics, preoperative laboratory values, inflammatory indices - including neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) - were evaluated, along with hospital length of stay and histopathological outcomes.
Results:
Among 249 patients, 34 (13.6%) were diagnosed with AC, comprising 76 males (30.5%) and 173 females (69.5%), with a mean age of 48.9 ± 14.6 years. The median hospital length of stay was 3 days (range: 1-21). Significant elevations in both the SIRI and neutrophil count were observed in AC cases compared to controls (P < 0.001). ROC (receiver operating characteristic) curve analysis demonstrated comparable diagnostic performance for the SIRI (AUC = 0.746; 95% CI: 0.658-0.835; optimal cutoff: 1.98) and neutrophil count (AUC = 0.746; 95% CI: 0.658-0.835; optimal cutoff: 7.1 × 103/μL) in predicting AC.
Conclusions:
The SIRI and neutrophil count are reliable markers that can improve the diagnostic accuracy and guide early management of AC.
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