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

Abstract

Introduction Acute appendicitis is one of the most common surgical emergencies worldwide. Clinical scoring system systems have been developed to diagnose acute appendicitis, but insufficient to predict the complication. The amount of serum biomarkers elevates in response to acute inflammation, which could be beneficial for diagnostic tools. Accordingly, a meta-analysis was conducted to evaluate the efficacy of platelet indices, including mean platelet volume (MVP) and platelet distribution width (PDW) as potential biomarkers for the diagnosis of a diagnosis of acute appendicitis. Material and methods The dataset was defined by searching for articles published until December 2020 from PubMed, EMBASE, Google Scholar and the Cochrane database. The meta-analysis was performed using Review Manager Software version 5.4.1. Results The final analysis was made from 9 studies, including 3124 patients. The results demonstrated that lower MPV values was significantly associated with acute appendicitis (odds ratio (OR) = 0.81, 95% confidence interval (CI) = −1.51 to −0.11, P = 0.02), but not associated with complicated appendicitis by comparing it with the control (OR = −0.13,95% CI = −0.33 to −0.07, P = 0.19) and non-complicated appendicitis groups (OR = −0.13,95% CI = −0.30 to −0.04, P = 0.14). The present study failed to demonstrate the diagnostic value of PDW for the prediction of appendicitis and its complication. Conclusion The results of the meta-analysis strongly indicate that a lower MVP values could function as a marker for predicting the acute appendicitis.

Predictive Value of Red Blood Cell Distribution Width, Mean Platelet Volume and Platelet Distribution Width in Children with Acute Appendicitis

“…A high value of MPV can be found in chronic diseases while lower MPV values can be found in acute diseases, such as acute appendicitis. PDW is an indicator of variation in platelet size, which can be a sign of active platelet release [5,6,17,18]. PDW, RDW, and platelet values in patients diagnosed with uncomplicated appendicitis may be a guide in choosing patients to be treated with antibiotics only [17].…”

“…PDW is an indicator of variation in platelet size, which can be a sign of active platelet release [5,6,17,18]. PDW, RDW, and platelet values in patients diagnosed with uncomplicated appendicitis may be a guide in choosing patients to be treated with antibiotics only [17].…”

Mean Platelet Volume in the Diagnosis of Acute Appendicitis in the Pediatric Population: A Systematic Review and Meta-Analysis

“…Fan et al performed a systematic review and meta-analysis on the correlation between AA and MPV and concluded that MPV was lower in patients with AA [ 8 ]. Tullavardhana et al looked at platelet indices in AA in a meta-analysis and suggested that lower MVP values could function as a marker of AA [ 32 ]. Shen et al concluded in their meta-analysis that only MPV, but no other platelet indices, vary in AA cases [ 33 ].…”

Neutrophil to Lymphocyte Ratio (NLR) as an Easily Accessible Parameter for Monitoring Tacrolimus Overdose after Heart Transplantation—Experimental Study

“…While we presented higher NLR reflecting inflammatory response related to tacrolimus overdose, higher MPV may result from the aforementioned platelet-to-leucocytes interaction. According to the meta-analysis conducted by Tullavardana et al, mean platelet volume (MVP) was a potential biomarker for the diagnosis of acute states, including appendicitis [ 30 ]. Meyer et al, in their study, presented inflammatory cascade induction via NF-κB9 (nuclear factor kappa-light-chain-enhancer of activated B cells), signaling endothelial colony progenitor cells induced by tacrolimus [ 31 ].…”