COVID-19 pandemisi süresince SIRI, SII ve Alvarado skorlarýnýn akut apandisit komplikasyonlarýyla olan iliþkisi

AMAÇ: COVID-19 pandemisi süresince SIRI (Systemic Inflammatory Response Index), SII (Systemic Inflammation Index) ve Alvarado skorlarýnda oluþan deðiþiklikleri araþtýrmak.
GEREÇ VE YÖNTEM: Mart 2019 ile Mart 2021 tarihleri arasýnda Edirne Trakya Üniversitesi’nde akut apandisit nedeniyle ameliyat edilmiþ olan 161 ardýþýk hastanýn dosyalarý geriye dönük olarak deðerlendirildi. Grup I’deki hastalar COVID-19 pandemi sürecinde ameliyat olan hastalardan oluþurken, Grup II’deki hastalar pandemik süreci öncesinde ameliyat olan hastalardan oluþmaktadýr. Grup I’de 80, Grup II’de 81 hasta bulunmak-tadýr. Nötrofil/lenfosit (NLR), trombosit/lenfosit (PLR) ve lenfosit/monosit (LMR) oranlarý hesaplandý. SII deðeri (trombosit x nötrofil/lenfosit) formülü kullanýlarak, SIRI deðeri ise (nötrofil x monosit/lenfosit) formülü kullanýlarak hesaplandý. Alvarado skoru ise hasta öyküsü, klinik muayene ve laboratuvar bulgularý kullanýlarak hesaplandý.
BULGULAR: Yer deðiþtiren aðrý, bulantý/kusma, sað alt kadran aðrýsý, rebound, yüksek ateþ, lökositoz ve toplam Alvarado skorlarý deðerlendiril-diðinde iki grup arasýnda belirgin fark saptandý (p<0.001). Ayný zamanda iki grup arasýnda CRP, SIRI ve SII deðerleri arasýnda belirgin farklýlýk oluðu görüldü (p<0.001). Bu parametrelerin hepsinde Grup I’deki deðerler Grup II’ye göre daha yüksek saptandý.
TARTIÞMA: Çalýþmamýzdan elde ettiðimiz verilere dayanarak COVID-19 pandemi sürecinde akut apandisit nedeniyle hastaneye baþvuran hasta oranýnda artýþ olduðu görüldü. Bununla birlikte COVID-19 pandemi sürecinde geç taný alýnmasý nedeniyle akut apandisit komplikasyonlarý daha fazla görülmüþtür. Akut apandisit hastalarýnda ameliyat öncesi veya sonrasý komplikasyonlarý göstermede Alvarado skoru, SIRI ve SII bir belirteç olarak kullanýlabilir. Ayný zamanda Alvarado skoru, SIRI ve SII deðerlerinin akut apandisit komplikasyonlarý ile orantýlý olarak deðiþkenlik gösterdiði görüldü.

Relationship between SIRI, SII values, and Alvarado score with complications of acute appendicitis during the COVID-19 pandemic

BACKGROUND: The aim of the study was to investigate the clinical variations of Systemic Inflammatory Response Index (SIRI), Systemic Inflammation Index (SII), and Alvarado Score during the COVID-19 pandemic period.
METHODS: Between March 2019 and March 2021, 161 consecutive patients who had surgery due to acute appendicitis were ret-rospectively recruited from Trakya University in Edirne, Turkey. Group I included patients who had surgery during the COVID-19 pandemic and Group II included patients who had surgery before the COVID-19 pandemic period. A total of 80 patients volunteered for Group I and 81 patients for Group II. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio, and lymphocyte/monocyte ratio were calculated. SII was calculated by the formula: platelet (P) × neutrophil (N)/lymphocyte (L). NLR was calculated by dividing the neutrophil count by the number of lymphocytes. SIRI was defined as follows: SIRI = (neutrophil × monocyte/lymphocyte). The Alvarado score was also calculated by using patient history, clinical examination, and laboratory findings.
RESULTS: There was a significant difference between the two groups in terms of displacing pain, nausea/vomiting, right lower quad-rant tenderness, rebound, hyperthermia, leukocytosis, and total Alvarado score (p<0.001). There was a significant difference between two groups in comparison of C-reactive protein, SIRI, and SII values (p<0.001). Group I patients had higher values of these parameters than Group II.
CONCLUSION: Based on the results obtained from this study, we conclude that COVID-19 pandemic has caused an increase in patients with acute appendicitis admitted to the hospital. This late diagnosis of acute appendicitis caused more complications during COVID-19 pandemic. Alvarado score, SIRI, and SII can be used as a marker to indicate whether complications of acute appendicitis occurred pre- or post-operatively. Therefore, Alvarado score, SIRI, and SII are directly proportional to the complication of acute appendicitis.