The diagnostic values of procalcitonin and interleukin 6 in acute appendicitis

Haghi, Alireza Rastgoo; Kasraianfard, Amir; Monsef, Alireza; Kazemi, Amin Shoa; Rahimi, Siavash; Javadi, Seyed Mohammad Reza

doi:10.5578/turkjsurg.4113

Cited by 12 publications

(13 citation statements)

References 12 publications

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“…PCT showed an Sn and Sp of 65% and 80%, respectively, suggesting a possible role in AA diagnosis. Finally, the authors highlighted how simultaneous high levels of PCT and IL-6 achieve an Sn of 95% and Sp of 55% [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

IL-6 Serum Levels Can Enhance the Diagnostic Power of Standard Blood Tests for Acute Appendicitis

et al. 2022

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Background: The diagnosis of acute appendicitis (AA) remains challenging, especially in pediatrics, because early symptoms are not specific, and the younger the patient the more difficult their interpretation is. There is a large degree of agreement between pediatric surgeons on the importance of an early diagnosis to avoid complicated acute appendicitis (CAA) and its consequences. The aim of this study is to assess if Interleukin 6 (IL-6) could enhance the sensitivity (Sn) and specificity (Sp) of the currently available and routinely performed diagnostic tools in case of suspected AA in pediatric patients. Materials and Methods: A prospective observational study was conducted including patients who underwent appendectomy between November 2020 and March 2022. We divided patients into three groups: not inflamed appendix (group NA), not complicated AA (group NCAA), and complicated AA (group CAA). We compared the mean values of white blood cells (WBC), neutrophils, fibrinogen, ferritin, aPTT, INR, C-reactive protein (CRP), IL-6, and CRP between the three groups. Then we evaluated Sn, Sp, and odds ratio (OR) of IL-6 and CRP alone and combined. Results: We enrolled 107 patients operated on for AA (22 in Group NA, 63 in Group NCAA, and 21 in group CAA). CRP levels resulted in a significant increase when comparing CAA with NA (p = 0.01) and CAA with NCAA (p = 0.01), whereas no significance was found between NA and NCAA (p = 0.38). A statistically significant increase in average IL-6 levels was found when comparing NCAA with NA (p = 0.04), CAA with NA (p = 0.04), and CAA with NCAA (p = 0.02). Considering CRP alone, its Sn, Sp, and OR in distinguishing NA from AA (both NCAA and CAA together) are 86%, 35%, and 33,17, respectively. Similarly, Sn, Sp, and OR of IL-6 alone are 82%, 54%, and 56, respectively. Combining CRP and IL-6 serum levels together, the Sn increases drastically to 100% with an Sp of 40% and OR of 77. Conclusions: Our study may suggest an important role of IL-6 in the detection of AA in its early stage, especially when coupled with CRP.

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Section: Discussionmentioning

confidence: 99%

IL-6 Serum Levels Can Enhance the Diagnostic Power of Standard Blood Tests for Acute Appendicitis

et al. 2022

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“…Haghi et al reported that combining PCT and IL-6 improved the diagnostic efficiency of infectious appendicitis and decreased unnecessary negative appendectomies [Haghi 2018]. Another study demonstrated that the combination of IL-6, CRP and PCT seems to be predictive in diagnosis of early onset neonatal sepsis [Abdollahi 2012].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Procalcitonin and Interleukin-6 on Early Postoperative Pneumonia after Adult Cardiac Surgery: A Prospective Observational Study

Xie

Chen

Zhang

et al. 2022

HSF

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Background: Postoperative pneumonia (PP) is the most common primary infection after cardiac surgery, increasing the hospitalization expense and causing the consumption of healthcare resources. This study aimed to investigate the diagnostic value of procalcitonin (PCT) and interleukin-6 (IL-6) on early postoperative pneumonia after adult cardiac surgery. Methods: In this prospective observational study, patients with pneumonia and age- and sex-matched cases in our center from October 10, 2020 to January 31, 2021 were included. Patients diagnosed with pneumonia in this study needed meet both clinical and microbiological diagnostic criteria. Blood samples were collected in all patients from postoperative day (POD) 1 to postoperative day 5 to detect PCT, IL-6, white blood cell count, and C-reactive protein. The diagnostic performance of different biomarkers was evaluated by the receiver operating characteristic curves and the area under the curves. Results: Our study enrolled 272 patients, including 24 patients with postoperative pneumonia and 248 age- and sex-matched cases. From POD1 to POD5, the absolute value of PCT and PCT variations showed diagnostic significance for pneumonia (P < .05); the diagnostic value of the absolute value of IL-6 and IL-6 variations was not satisfying. White blood cell count showed no differences; C-reactive protein had no diagnostic value before POD4. Multivariable logistic regression showed that PCT variation and IL-6 variation from POD3 to POD1 were the strongest risk factors for postoperative pneumonia [OR:12.50, 95% CI: (3.40-45.5); OR:13.71, 95% CI: (1.11-168.47)]. According to the above results, we defined the PL Index. PL Index showed the best diagnostic value among those biomarkers in POD3 [AUC: 0.90, 95% CI: (0.79-0.95)]. Multivariable logistic regression showed PL Index POD3 has significant correlation with postoperative pneumonia [OR:1.23, 95% CI: (1.11-1.37), P = .041]. Conclusions: PCT variation and IL-6 were more accurate than C-reactive protein and white blood cell count to predict early postoperative pneumonia, but the diagnostic properties of PCT could not be observed during the first three postoperative days due to the inflammatory process. By combining the variations of PCT and IL-6, we defined the PL Index, which shows the best diagnostic ability on early postoperative pneumonia after adult cardiac surgery.

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“…IL-6 is a proinflammatory cytokine, mediator of acute phase reaction, and is secreted during inflammatory process and neutrophil recruitment following the invasion of bacteria to the appendix [14,15]. Some of the previous studies have shown its relatively high sensitivity (73-84%) and low specificity (46-72%) for diagnosing AA and even higher sensitivity (up to 91%) and lower specificity (37%) for diagnosing perforated appendicitis [16,17]. Elevated serum IL-6 levels were found in the majority of our patients (55, 82.09%, p < 0.001).…”

Section: Discussionmentioning

confidence: 99%

The potential role of interleukin-6, endotoxin and C-reactive protein as standard biomarkers for acute appendicitis in adults

Dimić¹,

Dimic²,

Elek³

et al. 2022

Srp Arh Celok Lek

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Introduction/Objective. Acute appendicitis (AA) is by far the most frequent urgent condition in abdominal surgery and numerous biomarkers may help the physician to diagnose and even predict the severity of the disease. The objective of the paper was to determine the accuracy of C-reactive protein (CRP), interleukin-6 (IL-6) and endotoxin and compare it with the diagnostic value of Alvarado score (AS) in adults surgically treated for AA. Methods. Sixty-seven patients were diagnosed with AA using AS. Prior to surgery serum levels of inflammatory biomarkers were determined and together with AS were respectively compared to the results of histopathological analysis of specimens. The patients were divided into three group according to the histopathological assessment. Results. The univariate analysis revealed that the increase of CRP level by one unit increases the probability of complicated AA (CoAA) occurence by 1% (1.00 to 1.02, p < 0.05). ROC curve analysis has revealed that CRP has better capacity to predict supurative AA (SAAs)/CoAAs than catarrhal AA (CAA), with the cut-of value 19.45. Increase of AS value by one unit produced 2.98 fold increase of the probability of CoAA occurrence (1.60 to 5.57, p < 0.001), while positive AS value increases the probability of CoAA occurrence 24.67 times (4.94 to 123.12; p < 0.001). ROC curve analysis was demonstrated that AS may better predict CoAAs than CAAs/SAAs, with the cut-off value 8.50. Conclusion. AS and CRP should be routinely used combined as powerful tools for diagnosis and prediction of complicated AA.

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The diagnostic values of procalcitonin and interleukin 6 in acute appendicitis

Cited by 12 publications

References 12 publications

IL-6 Serum Levels Can Enhance the Diagnostic Power of Standard Blood Tests for Acute Appendicitis

IL-6 Serum Levels Can Enhance the Diagnostic Power of Standard Blood Tests for Acute Appendicitis

Diagnostic Value of Procalcitonin and Interleukin-6 on Early Postoperative Pneumonia after Adult Cardiac Surgery: A Prospective Observational Study

The potential role of interleukin-6, endotoxin and C-reactive protein as standard biomarkers for acute appendicitis in adults

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