Is the Hematologic Inflammatory Index Useful for Detecting Acute Appendicitis in Pediatric Patients?

Area of Science:

• Pediatric Surgery
• Clinical Diagnostics
• Inflammatory Markers

Background:

• Appendicitis is the most common surgical emergency in children, necessitating early and accurate diagnosis.
• Preventing complications and improving outcomes hinges on precise recognition of appendicitis.

Purpose of the Study:

• To evaluate the diagnostic performance of the Hematologic Inflammatory Index (HII) in children with suspected appendicitis.
• To assess HII's utility in guiding surgical decisions for pediatric appendicitis.

Main Methods:

• A study involving 349 pediatric patients (5-18 years) with abdominal pain.
• Comparison of laboratory markers, including HII, between confirmed acute appendicitis (AA) and non-acute appendicitis (non-AA) groups.
• Receiver-operating characteristic (ROC) analysis to determine HII's diagnostic accuracy.

Main Results:

• Patients with AA showed significantly elevated white blood cells, neutrophil count, C-reactive protein, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and HII.
• HII achieved 78% sensitivity and 62% specificity for predicting AA at a cutoff of >0.86.
• Lower lymphocyte and platelet counts were observed in the AA group.

Conclusions:

• While HII values were higher in pediatric appendicitis, its diagnostic accuracy was insufficient for standalone use.
• HII did not prove to be a reliable tool for guiding surgical decision-making in pediatric appendicitis cases.