Can Platelet Indices Reduce Negative Appendectomy Rates?

Abstract

Introduction The role of whole blood count parameters in the diagnosis of diseases in which inflammatory processes play a role is one of the more frequently mentioned topics in the literature in recent years. Studies of acute appendicitis have also been carried out in this regard, but studies focused on platelet parameters are few and contradictory. We aimed to investigate the role of mean platelet volume (MPV) and platelet distribution width (PDW) in the diagnosis of acute appendicitis. Materials and methods We retrospectively screened the medical records of patients older than 15 years who had an appendectomy from January 2012 to January 2015 at a training hospital in Kocaeli, Turkey. Patients were divided into three groups according to their pathology results: non-appendicitis (Group 1), uncomplicated appendicitis (Group 2), and complicated appendicitis (Group 3). We calculated the sensitivity, specificity, positive and negative predictive values, the likelihood ratios in the diagnosis of appendicitis for white blood cell (WBC), neutrophil count, c-reactive protein (CRP), MPV, and PDW values were calculated. Results There were no significant differences in the MPV between Group 1 (n = 39; 7.89 ± 1.32 fL), Group 2 (n = 119; 7.80 ± 1.19 fL), and Group 3 (n = 89; 7.70 ± 0.80 fL; p = 0.141). Also, we found no significant differences in PDW between Group 1 (117.38% ± 1.17), Group 2 (17.17% ± 1.04), and Group 3 (17.12% ± 0.64; p = 0.228). Conclusions Only nine of the 208 patients whose pathology reports confirmed appendicitis had healthy values for both CRP and WBC. Many factors affect MPV and PDW. Therefore, platelet indices are not useful markers in diagnosing acute appendicitis.

Role of platelet indices as a biomarker for the diagnosis of acute appendicitis and as a predictor of complicated appendicitis: A meta-analysis

“…The initial search identified a total of 101 potential articles. After screening, nine articles that matched the researchers’ criteria were deemed suitable for inclusion in the meta-analysis [ [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] ]. The PRISMA diagram used in the search process is shown in Fig.…”

“…Seven studies [ [21] , [22] , [23] , 25 , 25 , 27 , 29 ] reported an association between MPV and acute appendicitis, with a total of 2142 patients (1406 patients [68%] in the acute appendicitis group and 736 patients [32%] in the control group). Pooled analysis of the seven studies demonstrated that the MPV among patients with acute appendicitis was significantly lower than the control group (OR = −0.81,95% CI = −1.51 to −0.11, P = 0.02).…”

“…Four studies [ 24 , [26] , [27] , [28] ] reported an association between MPV and complicated appendicitis, with a total of 450 patients (235 patients [52%] in the complicated appendicitis group and 215 patients [48%] in the control group). The pooled analysis demonstrated that MPV appeared to reduce in the complicated appendicitis group, but was not significantly different (OR = −0.13,95% CI = −0.33 to −0.07, P = 0.19).…”

“…Three studies [ 22 , 26 , 27 ] with a total of 767 patients included 513 (67%) patents in the acute appendicitis group and 254 (33%) patients in the control group. The pooled analysis did not demonstrate significant difference in PDW between both patient groups (OR = 1.19,95% CI = −0.59 – 2.97, P = 0.19).…”

“…Two studies [ 26 , 27 ] investigated the association between PDW and complicated appendicitis which included 153 patients (59 [39%] patients in the complicated appendicitis group and 94 [61%] in the control group). The pooled analysis demonstrates no significant difference in PDW between the complicated appendicitis and control groups (OR = −0.83,95% CI = −2.10 – 0.44, P = 0.20).…”