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Can Platelet Indices Reduce Negative Appendectomy Rates?

ABSTRACT: Introduction The role of whole blood count parameters in the diagnosis of diseases in which inflammatory processes play a role is one of the more frequently mentioned topics in the literature in recent years. Studies of acute appendicitis have also been carried out in this regard, but studies focused on platelet parameters are few and contradictory. We aimed to investigate the role of mean platelet volume (MPV) and platelet distribution width (PDW) in the diagnosis of acute appendicitis. Materials and methods We retrospectively screened the medical records of patients older than 15 years who had an appendectomy from January 2012 to January 2015 at a training hospital in Kocaeli, Turkey. Patients were divided into three groups according to their pathology results: non-appendicitis (Group 1), uncomplicated appendicitis (Group 2), and complicated appendicitis (Group 3). We calculated the sensitivity, specificity, positive and negative predictive values, the likelihood ratios in the diagnosis of appendicitis for white blood cell (WBC), neutrophil count, c-reactive protein (CRP), MPV, and PDW values were calculated. Results There were no significant differences in the MPV between Group 1 (n = 39; 7.89 ± 1.32 fL), Group 2 (n = 119; 7.80 ± 1.19 fL), and Group 3 (n = 89; 7.70 ± 0.80 fL; p = 0.141). Also, we found no significant differences in PDW between Group 1 (117.38% ± 1.17), Group 2 (17.17% ± 1.04), and Group 3 (17.12% ± 0.64; p = 0.228). Conclusions Only nine of the 208 patients whose pathology reports confirmed appendicitis had healthy values for both CRP and WBC. Many factors affect MPV and PDW. Therefore, platelet indices are not useful markers in diagnosing acute appendicitis.

SUBMITTER: Yigit Y

PROVIDER: S-EPMC6538231 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Can Platelet Indices Reduce Negative Appendectomy Rates?

Yigit Yavuz Y Yilmaz Serkan S Ozbek Asim E AE Karakayali Onur O Cetin Bilen B Halhalli Huseyin C HC

Cureus 20190321 3

Introduction The role of whole blood count parameters in the diagnosis of diseases in which inflammatory processes play a role is one of the more frequently mentioned topics in the literature in recent years. Studies of acute appendicitis have also been carried out in this regard, but studies focused on platelet parameters are few and contradictory. We aimed to investigate the role of mean platelet volume (MPV) and platelet distribution width (PDW) in the diagnosis of acute appendicitis. Materia ...[more]

PMID: 31183274

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Project description:BackgroundThe commonly available platelet indices are platelet distribution width (PDW), plateletcrit (PCT), and mean platelet volume (MPV). They have been used in diagnosis and prognosis of various abdominal disorders. They have never been used to predict severity of alcoholic hepatitis.MethodsA retrospective analysis of chronic alcohol consumers presenting with jaundice and deranged liver function tests was performed. Maddrey discriminant function (MDF) and modified end-stage liver disease (MELD) scores were calculated and patients compared between severe and nonsevere alcoholic hepatitis (MDF ≥32 vs MDF <32 and MELD >20 vs MELD ≤20). Logistic regression analysis was performed to find significant predictors. Receiver operating characteristic was used to find the area under the curve. Spearman correlation was performed to discover association between platelet indices and severity scores.ResultsThere were 119 patients in the study. Coexisting illnesses included pancreatitis, cirrhosis, infections, and alcohol withdrawal syndrome. The mean age (years), duration of alcohol consumption (years), and ethanol (g/day) were 45.13 ± 11.53, 18.84 ± 11.40, and 65.61 ± 45.42, respectively. The average MELD and Maddrey scores were 14.13 ± 5.17 and 36.45 ± 29.63, respectively. The mean platelet counts, PDW, MPV, and PCT were 194.01 ± 178.82 × 109/L, 17.10 ± 1.21, 5.99 ± 0.96, and 0.14 ± 0.04, respectively. PDW >18 and MPV had a significant positive correlation with MELD scores. Only bilirubin and prothrombin prolongation were significant predictors of severe alcoholic hepatitis. The area under the curve was highest for PCT at 0.622 (P = .07; confidence interval = 0.500-0.743).ConclusionsPlatelet indices appear to be significantly altered in alcoholic hepatitis, but they do not predict severe disease. Whether this inability to predict severe alcoholic hepatitis is due to coexisting illnesses such as pancreatitis, cirrhosis, and infection needs to be studied further.

Project description:BackgroundSocial vulnerability indices were created to measure resiliency to environmental disasters based on socioeconomic and population characteristics of discrete geographic regions. They are composed of multiple validated constructs that can also potentially identify geographically vulnerable populations after injury. Our objective was to determine if these indices correlate with injury fatality rates in the US.MethodsWe evaluated three social vulnerability indices: The Hazards & Vulnerability Research Institute's Social Vulnerability Index (SoVI), the Center for Disease Control's Social Vulnerability Index (SVI), and the Economic Innovation Group's Distressed Community Index (DCI). We analyzed SVI subindices and common individual census variables as indicators of socioeconomic status. Outcomes included age-adjusted county-level overall, firearm, and motor vehicle collision deaths per 100,000 population. Linear regression determined the association of injury fatality rates with the SoVI, SVI, and DCI. Bivariate choropleth mapping identified geographic variation and spatial autocorrelation of overall fatality, SoVI, and DCI.ResultsA total of 3,137 US counties were included. Only 24.6% of counties fell into the same vulnerability quintile for all three indices. Despite this, all indices were associated with increasing fatality rates for overall, firearm, and motor vehicle collision fatality. The DCI performed best by model fit, explanation of variance, and diagnostic performance on overall injury fatality. There is significant geographic variation in SoVI, DCI, and injury fatality rates at the county level across the United States, with moderate spatial autocorrelation of SoVI (Moran's I, 0.35; p < 0.01) and high autocorrelation of injury fatality rates (Moran's I, 0.77; p < 0.01) and DCI (Moran's I, 0.53; p < 0.01).ConclusionWhile the indices contribute unique information, higher social vulnerability is associated with higher injury fatality across all indices. These indices may be useful in the epidemiologic and geographic assessment of injury-related fatality rates. Further study is warranted to determine if these indices outperform traditional measures of socioeconomic status and related constructs used in trauma research.Level of evidenceEpidemiological, level IV.

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Can Platelet Indices Reduce Negative Appendectomy Rates?

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Can Platelet Indices Reduce Negative Appendectomy Rates?

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