Cellular indices and acute phase reactants as predictors of abscess after appendectomy.

OBJECTIVE

To compare the accuracy of four biomarkers as predictors of post-appendectomy abdominal abscess (PAA).

METHODS

Diagnostic study of patients under 15 years of age operated for appendicitis in a pediatric hospital between 2010 and 2022 was analyzed. Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), C-reactive protein (CRP) and procalcitonin (PCT) were compared between patients with PAA and those without such complication (NPAA).

RESULTS

86 patients with PAA (64% men; mean age: 9.4 ± 3.5 years) and 91 patients NPAA (65% men; mean age: 10.2 ± 2.9 years) were included. NLR, PLR, CRP and PCT values were higher in the PAA group than in the NPAA group (p < 0.0001). PCT had the highest area under the ROC curve (0.761), a cutoff point of 0.37, sensitivity 74%, specificity 75%, and positive predictive value of 74% for predicting the occurrence of PAA.

CONCLUSIONS

PCT is a good predictor of abdominal abscess after appendectomy. Considering preoperative PCT values to optimize postoperative management and antibiotics could be an additional tool in the prevention of this complication.