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Cellular indices and acute phase reactants as predictors of abscess after appendectomy
Julio C Moreno-Alfonso1,2, Laura C Lozano-Eslava3, Sharom Barbosa-Velásquez4
1Servicio de Ciruguía Pediátrica, Hospital Universitario de Navarra, Pamplona, España.
Cirugia Y Cirujanos
|January 20, 2026
Summary
Procalcitonin (PCT) effectively predicts post-appendectomy abdominal abscess (PAA) in children. Elevated preoperative PCT levels can aid in optimizing patient management and preventing PAA complications.
Area of Science:
- Pediatric Surgery
- Infectious Disease Diagnostics
- Biomarker Research
Background:
- Post-appendectomy abdominal abscess (PAA) is a significant complication following appendicitis surgery in children.
- Accurate prediction of PAA is crucial for timely intervention and improved patient outcomes.
- Several biomarkers, including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), C-reactive protein (CRP), and procalcitonin (PCT), are investigated for their predictive value.
Purpose of the Study:
- To evaluate and compare the accuracy of four biomarkers (NLR, PLR, CRP, PCT) in predicting PAA in pediatric patients.
- To identify the most effective biomarker for early detection of PAA.
- To inform clinical decision-making regarding postoperative management and antibiotic use.
Main Methods:
- A retrospective diagnostic study analyzed pediatric patients (<15 years) who underwent appendectomy between 2010 and 2022.
- Biomarker levels (NLR, PLR, CRP, PCT) were compared between patients who developed PAA and those who did not (NPAA).
- Receiver Operating Characteristic (ROC) curve analysis was used to assess the predictive accuracy of each biomarker.
Main Results:
- The study included 86 patients with PAA and 91 patients with NPAA.
- All four biomarkers (NLR, PLR, CRP, PCT) showed significantly higher levels in the PAA group compared to the NPAA group (p < 0.0001).
- Procalcitonin (PCT) demonstrated the highest predictive accuracy with an area under the ROC curve of 0.761, a sensitivity of 74%, and specificity of 75% at a cutoff of 0.37.
Conclusions:
- Procalcitonin (PCT) is a valuable and accurate biomarker for predicting the occurrence of post-appendectomy abdominal abscess in pediatric patients.
- Preoperative PCT levels can serve as an additional tool to optimize postoperative management strategies and guide antibiotic therapy, potentially preventing PAA.
- Further research could explore integrating PCT into routine postoperative monitoring protocols for appendicitis patients.
Keywords:
Abdominal abscessAbsceso abdominalApendicitisAppendicitisC-reactive proteinNeutrophil-lymphocyte ratioPlatelet-lymphocyte ratioProcalcitoninProcalcitoninaProteína C reactivaÍndice neutrófilo-linfocitoÍndice plaqueta-linfocitoMore Related Videos
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