Mean Platelet Volume and Platelet Distribution Width as Markers in the Diagnosis of Acute Gangrenous Appendicitis

Abstract

Introduction. Acute gangrenous appendicitis (AGA) is a common medical condition; however, the grade of appendicitis usually cannot be established preoperatively. We have attempted to identify some indicators, such as the mean platelet volume (MPV) and the platelet distribution width (PDW), to diagnose AGA. Aims. To evaluate whether or not the MPV and PDW are suitable markers to diagnose AGA. Methods. A retrospective study of 160 patients with AGA and 160 healthy patients was undertaken. Disease diagnosis was confirmed based on the pathologic examination of surgical specimens. Patient white blood cell (WBC) count, neutrophil ratio (NR), platelet (PLT) count, MPV, PDW, and hematocrit (HCT) were analyzed. Receiver operating characteristic (ROC) curves were used to evaluate the sensitivity and specificity of these indices in AGA. Results. There were no significant differences between the AGA and control groups in age and gender. Compared to the control group, the WBC count, NR, and PDW were significantly higher (P < 0.001, resp.) and the MPV and HCT were significantly lower (P < 0.001, resp.) in the AGA group. The diagnostic specificities of the WBC count, NR, PLT count, MPV, PDW, and HCT were 86.3%, 92.5%, 58.1%, 81.7%, 83.9%, and 66.3%, respectively. Therefore, the NR had the highest diagnostic specificity for the diagnosis of AGA. Conclusions. This is the first study to assess the MPV and PDW in patients with AGA. Our present study showed that the MPV is reduced and the PDW is increased in patients with AGA; the sensitivity of PDW was superior to the MPV. A decreased MPV value and an increased PDW could serve as two markers to diagnose AGA. The NR had the highest specificity for the diagnosis of AGA.

How To Avoid Negative Appendectomies: Can Us Achieve This?

“…[7] However, diagnosis of appendicitis usually cannot be evaluated only based on these examinations. [8] Multiple scoring systems, such as the Alvarado and modified Alvarado scoring systems, have been used to improve the accuracy of diagnosis of acute appendicitis. [9][10][11] These scoring systems have proven successful in Western countries; however, when applied in different environments, such as the Middle East and Asia, sensitivity and specificity levels achieved have been very low.…”

Investigation of the Diagnostic Value of Neutrophil to Lymphocyte Ratio in Pediatric Appendicitis Cases

“…Complete blood count (CBC) is in the first line of laboratory evaluation to diagnose appendicitis (6,7). White blood cell count (WBC) is studied well in the literature, but recently, there are several CBC parameters such as red blood cell distribution width (RDW), mean platelet volume (MPV), and platelet distribution width (PDW) associated with the diagnosis of appendicitis (8)(9)(10)(11). In recent studies, neutrophil-to-lymphocyte ratio (NLR) is reported associated with several surgical clinical conditions as appendicitis, acute mesenteric ischemia, and strangulated inguinal hernia (12)(13)(14).…”

Evaluation of Complete Blood Count Parameters Before and After Appendectomy

“…There are other studies supporting this conclusion (11,16,17). In contrast to both studies, other studies with larger patient groups reported no changes in MPV values (13,18,19).…”

“…In a study of 295 patients in 2015, Uyanik et al (20) reported a statistically significant decrease in MPV values together with a decrease in PDW. In contrast, Fan et al (17) reported a statistically significant increase in PDW values and a statistically significant increase in MPV values in AA patients. In contrast to several previous studies, our findings indicate that platelet markers such as PDW, PCT and MPV are not useful in the diagnosis of AA and in predicting its severity, since they exhibit a hemodilutional decrease related to hydration therapy.…”