Akile Zengin, Yusuf Murat Bağ, Mehmet Zeki Öğüt, Kutay Sağlam
{"title":"The role of C-reactive protein/albumin ratio and prognostic nutritional index in the diagnosis of complicated acute appendicitis","authors":"Akile Zengin, Yusuf Murat Bağ, Mehmet Zeki Öğüt, Kutay Sağlam","doi":"10.47717/turkjsurg.2024.6301","DOIUrl":null,"url":null,"abstract":"Objective: C-reactive protein (CRP) levels increase and albumin levels decrease in patients with inflammation. CRP/albumin ratio (CAR) is a new inflammation-associated prognostic indicator. The prognostic nutritional index (PNI) was described as a simple and neutral indicator of adverse outcomes not only in chronic diseases but also in acute conditions. The aim of this study was to investigate the clinical significance of the CAR and PNI value in differentiating complicated acute appendicitis (AA).\n Material and Methods: We retrospectively examined the medical records of 187 patients with AA. Patients were divided into two groups according to pathological results [non-complicated (n= 161) and complicated (n= 26)]. Demographic, clinical, laboratory, and pathological data were examined and compared between the groups. Logistic regression analyses were performed to determine the independent predictors for complicated AA.\n Results: Median age of the study group was 32 (23-41) years, and most of the patients were males (n= 101, 54%). Patients in the complicated AA group were significantly older compared to the patients in the non-complicated AA group [38 (32-49.5) years vs. 30 (22-41) years, p= 0.002]. The complicated AA group had significantly higher CAR level compared to the non-complicated AA group (p= 0.001). The length of hospital stay was significantly longer in the complicated AA group compared to the non-complicated AA group [2.5 (2-4.25) days vs. 1 (1-2) days, p< 0.001]. Other variables (including PNI) did not significantly differ between the groups. In univariate logistic regression analysis, only age was found to be a significant variable (OR= 1.045, 95% CI= 1.016-10.74, p= 0.002), but in multiple variate logistic regression analysis, no variable was found to be significant in predicting complicated AA.\n Conclusion: We concluded that CAR and PNI value are not independent predictors of complicated AA.","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.5000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Turkish Journal of Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.47717/turkjsurg.2024.6301","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: C-reactive protein (CRP) levels increase and albumin levels decrease in patients with inflammation. CRP/albumin ratio (CAR) is a new inflammation-associated prognostic indicator. The prognostic nutritional index (PNI) was described as a simple and neutral indicator of adverse outcomes not only in chronic diseases but also in acute conditions. The aim of this study was to investigate the clinical significance of the CAR and PNI value in differentiating complicated acute appendicitis (AA).
Material and Methods: We retrospectively examined the medical records of 187 patients with AA. Patients were divided into two groups according to pathological results [non-complicated (n= 161) and complicated (n= 26)]. Demographic, clinical, laboratory, and pathological data were examined and compared between the groups. Logistic regression analyses were performed to determine the independent predictors for complicated AA.
Results: Median age of the study group was 32 (23-41) years, and most of the patients were males (n= 101, 54%). Patients in the complicated AA group were significantly older compared to the patients in the non-complicated AA group [38 (32-49.5) years vs. 30 (22-41) years, p= 0.002]. The complicated AA group had significantly higher CAR level compared to the non-complicated AA group (p= 0.001). The length of hospital stay was significantly longer in the complicated AA group compared to the non-complicated AA group [2.5 (2-4.25) days vs. 1 (1-2) days, p< 0.001]. Other variables (including PNI) did not significantly differ between the groups. In univariate logistic regression analysis, only age was found to be a significant variable (OR= 1.045, 95% CI= 1.016-10.74, p= 0.002), but in multiple variate logistic regression analysis, no variable was found to be significant in predicting complicated AA.
Conclusion: We concluded that CAR and PNI value are not independent predictors of complicated AA.
目的:炎症患者的 C 反应蛋白(CRP)水平会升高,而白蛋白水平会降低。CRP/白蛋白比值(CAR)是一种新的炎症相关预后指标。预后营养指数(PNI)被描述为一种简单而中性的不良预后指标,不仅适用于慢性疾病,也适用于急性疾病。本研究旨在探讨 CAR 和 PNI 值在鉴别复杂性急性阑尾炎(AA)方面的临床意义。材料和方法:我们回顾性研究了 187 例 AA 患者的病历。根据病理结果将患者分为两组[非复杂性(161 人)和复杂性(26 人)]。我们对两组患者的人口统计学、临床、实验室和病理学数据进行了研究和比较。进行逻辑回归分析以确定复杂性 AA 的独立预测因素。研究结果研究组的中位年龄为 32(23-41)岁,大多数患者为男性(101 人,54%)。与非复杂性 AA 组患者相比,复杂性 AA 组患者的年龄明显偏大 [38 (32-49.5) 岁 vs. 30 (22-41) 岁,P= 0.002]。复杂 AA 组的 CAR 水平明显高于非复杂 AA 组(P= 0.001)。与非复杂 AA 组相比,复杂 AA 组的住院时间明显更长 [2.5 (2-4.25) 天 vs. 1 (1-2) 天,p< 0.001]。其他变量(包括 PNI)在两组间无明显差异。在单变量逻辑回归分析中,发现只有年龄是一个重要变量(OR= 1.045,95% CI= 1.016-10.74,p= 0.002),但在多变量逻辑回归分析中,没有发现任何变量对预测复杂性 AA 有重要意义。结论我们得出结论,CAR 和 PNI 值不是复杂 AA 的独立预测因子。