Role of immature granulocytes and total bilirubin values in the diagnosis of perforated appendicitis in patients over 65 years

Abstract

OBJECTIVE:The aim of this study was to investigate the effectiveness of immature granulocyte count, immature granulocyte percentage, and total bilirubin value in predicting complicated and perforated appendicitis in patients aged 65 years and older with a diagnosis of appendicitis. METHODS: In this study, 84 patients, aged 65 years and older, who had appendectomy demographic information, preoperative white blood cell count, neutrophil/lymphocyte ratio, immature granulocyte count and immature granulocyte percentage, operation findings, and pathology results were collected retrospectively. They were grouped into 4 categories: complicated, non-complicated, perforated, and non-perforated, according to the data and surgical findings. RESULTS: Total bilirubin and immature granulocyte count were found to be statistically significant in predicting complicated and perforated appendicitis in patients aged 65 years and older with a diagnosis of appendicitis. The total bilirubin was found to have the following values in differentiating complicated appendicitis: area under the curve=0.883, sensitivity=78.3%, and specificity=88.5%. Total bilirubin had the highest discrimination power with area under the curve=0.804 in differentiating perforation. CONCLUSION: The immature granulocyte percentage and total bilirubin count are the fast, inexpensive, and reliable parameters that can be used to predict complicated and perforated appendicitis in patients aged 65 years and older.

The role of infectious parameters in the early prediction of complicated colonic diverticulitis

“…IG% has been shown to provide valuable insights into disease severity in conditions with severe inflammation, such as acute necrotizing pancreatitis, acute cholecystitis, and perforated appendicitis. [ 12 , 13 , 29 , 30 ] However, some studies indicate that IG% might not offer additional benefits compared to other inflammatory markers. [ 31 , 32 ] In our study, no statistically significant difference in IG% values was found between complicated and uncomplicated acute diverticulitis patients.…”