Is the Hematologic Inflammatory Index Useful for Detecting Acute Appendicitis in Pediatric Patients?

OBJECTIVE

Appendicitis represents the most frequent cause of emergency abdominal surgery in children. Early and precise recognition is essential to prevent complications and improve clinical outcomes. The research aimed to investigate the diagnostic performance of Hematologic Inflammatory Index (HII) in children suspected of appendicitis, while also evaluating its contribution to surgical decision-making.

MATERIALS AND

METHODS

A total of 349 patients (aged 5-18 years) admitted with abdominal pain were evaluated. Patients were categorized into 2 groups: cases with histopathologically confirmed acute appendicitis (AA, n=132) and cases with non-acute appendicitis (non-AA, n=217). Laboratory variables, such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and HII were recorded. Hematologic Inflammatory Index was calculated as: HII = platelet / (neutrophil × lymphocyte) × 100. Receiver-operating characteristic analysis was used to assess the diagnostic accuracy of HII.

RESULTS

Children in the AA group exhibited significantly higher white blood cells, neutrophil count, C-reactive protein, NLR, PLR, and HII values, along with lower lymphocyte and platelet counts, compared with the non-AA group (P < .05). For predicting AA, HII demonstrated a sensitivity of 78% and specificity of 62% at a cutoff value of >0.86.

CONCLUSION

Although HII values were higher in pediatric appendicitis cases, the index did not demonstrate sufficient accuracy to serve as a reliable standalone diagnostic tool or to meaningfully guide surgical decision-making.