The Impact of Systemic Inflammation Index and Systemic Inflammatory Response Index on Predicting Acute Appendicitis Complications in Children Under Five Years Old

Abstract

Objective The aim of our study is to determine the value of SII (Systemic Inflammation Index) and SIRI (Systemic Inflammatory Response Index), biomarkers whose usage has increased in recent years, in predicting acute appendicitis complications in children under five years old. Specifically, due to the difficulty in diagnosing and managing acute appendicitis in children under five, we aimed to investigate the usability of these indices in determining the risk of complications of acute appendicitis and in developing clinical management strategies. Materials and Methods The study was conducted with 178 patients who met the inclusion and exclusion criteria. The laboratory values, surgical notes, and pathology results of the cases were recorded from patient files and the automation system, and statistical analyses were performed. Results The laboratory values of Platelet, Monocyte, SIRI, CRP, and Procalcitonin in the complicated appendicitis group were higher compared to those in the simple appendicitis group (p = 0.046; p = 0.035; p = 0.042; p = 0.001; p = 0.001, respectively). According to the results of the ROC Curve test, the SIRI score had an AUC of 59%, sensitivity of 67.37%, and specificity of 54.43%, while the CRP value had the best diagnostic test performance in predicting complicated appendicitis with an AUC value of 64.3%, sensitivity of 63.54%, and specificity of 61.25%. Conclusion In our study evaluating SII and SIRI, we found that especially SIRI, along with CRP and procalcitonin, was higher in the complicated group. However, the predictive power of CRP for complications was greater than these indices. We believe that randomized controlled and larger studies should be conducted to evaluate the use of these new-generation markers in acute appendicitis.