Ulus Travma Acil Cerrahi Derg. 2021; 27(1): 26-33 | DOI: 10.14744/tjtes.2020.69091

Acil serviste akut apandisit ile renal kolik ayýrýcý tanýsýnda hemogram parametrelerinin etkinliði

Ahmet Sönmez¹, Akkan Avcý¹, Gökben Sönmez¹, Müge Gülen¹, Selen Acehan¹, Begüm Þeyda Avcý², Adnan Kuvvetli³, Salim Satar^1
1Saðlýk Bilimleri Üniversitesi, Adana Þehir Eðitim ve Araþtýrma Hastanesi, Acil Týp Kliniði, Adana
²Saðlýk Bilimleri Üniversitesi, Adana Þehir Eðitim ve Araþtýrma Hastanesi, Ýç Hastalýklarý Kliniði, Adana
³Saðlýk Bilimleri Üniversitesi, Adana Þehir Eðitim ve Araþtýrma Hastanesi, Genel Cerrahi Kliniði, Adana

AMAÇ: Acil serviste akut apandisit ile renal kolik’in ayýrýcý tanýsýnda WBC, PLR ve NLR deðerlerinin etkinliðini araþtýrmaktýr.
GEREÇ VE YÖNTEM: Çalýþmaya Çukurova Üniversitesi Týp Fakültesi Giriþimsel Olmayan Klinik Araþtýrmalar Etik Kurulu’nun onayý alýndýktan sonra baþlandý. Hastane otomasyon ve arþiv sisteminde dosya verilerine tam olarak ulaþýlan toplam 440 hasta çalýþmaya dahil edildi.
BULGULAR: Çalýþmaya alýnan 440 hastanýn %59.5’i erkek (n=262), %40.5’i (n=202) ise kadýndý. Hastalarýn yaþ ortalamasý 37.74±13.39/yýl idi. Hastalarýn patolojik tanýsýna göre, 207 hastanýn akut apandisitle uyumlu olduðu tespit edildi. Hematolojik parametrelerin ayýrýcý tanýda kullaným etkinliði ROC analizi ile incelendiðinde en güçlü tahmin etme özelliðine nötrofil/lenfosit oranýnýn (NLR) sahip olduðu saptandý (AUC, 0.716, SS=0.024, %95 GA 0.668–0.764). NLR’den sonra ikinci sýrada platelet/lenfosit oranýnýn (PLR) ayýrýcý tanýda güçlü tahmin edici olduðu saptandý (AUC, 0.608, SS=0.027, %95 GA 0.555–0.661).
TARTIÞMA: Akut apandisit ve renal kolik akut abdominal aðrý ile acil servise sýklýkla baþvurmaktadýr. Akut apandisitli hastalar cerrahi yöntemler ile tedavi edilirken, renal kolikli hastalarda akut dönemde týbbi tedavi uygulanmaktadýr. Bu iki hasta grubunun ayýrýcý tanýsýnýn net olarak yapýlmasý önem arz etmektedir. PLR ve NLR deðerlerinin ayýrýcý tanýnýn net olarak yapýlamadýðý durumlarda kullanýlabileceðini düþünmekteyiz.

Anahtar Kelimeler: Akut apandisit, NLR; PLR; renal kolik.

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The efficacy of hemogram parameters in the differential diagnosis of renal colic and acute appendicitis in the emergency department

Ahmet Sönmez¹, Akkan Avcý¹, Gökben Sönmez¹, Müge Gülen¹, Selen Acehan¹, Begüm Þeyda Avcý², Adnan Kuvvetli³, Salim Satar^1
1Department of Emergency Medicine, Health Science University, Adana City Training and Research Hospital, Adana-Turkey
²Department of Internal Medicine, Health Science University, Adana City Training and Research Hospital, Adana-Turkey
³Department of General Surgery, Health Science University, Adana City Training and Research Hospital, Adana-Turkey

BACKGROUND: To investigate the efficacy of WBC, PLR and NLR for use in the differential diagnosis of acute appendicitis and renal colic in the emergency department.
METHODS: This study was conducted after consent was received from the Cukurova University Medicine Faculty Noninvasive Clinical Research Ethics Committee. In this study, 440 patients for whom file data could be accessed in the hospital automation and archive system who were admitted to the hospital with abdominal pain were included.
RESULTS: Of the 440 patients included in this study, 59.5% were male and 40.5% were female. The average age of the patients was 37.74±13.39 years. According to the pathological diagnosis, 207 patients were diagnosed with acute appendicitis. When the efficacy of differential diagnosis using hematological parameters was examined with ROC analysis, the neutrophil/lymphocyte ratio (NLR) value had the strongest predictive ability (AUC, 0.716, SS=0.024, 95% GA 0.668–0.764). After NLR, the platelet/lymphocyte ratio (PLR) value was the second-best concerning predictive ability for differential diagnosis (AUC, 0.608 SS=0.027, 95%, GA 0.555–0.661).
CONCLUSION: Patients with acute appendicitis and renal colic often present to the emergency department with abdominal pain. While patients with acute appendicitis are usually treated with surgical methods, medical treatment is used for renal colic in the acute period. The differential diagnosis of these two patient groups is important. We believe that the PLR and NLR values can be used when an exact differential diagnosis cannot be made.

Keywords: Acute appendicitis, neutrophil/lymphocyte ratio; platelet/lymphocyte ratio; renal colic.

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