Sodium Levels and Leukocyte Levels as Predictor Factors in Cases of Pediatric Perforated Appendicitis

Authors

  • Muhamad Givari Medical School, Andalas University, Padang, West Sumatra, Indonesia

DOI:

https://doi.org/10.55324/ijoms.v2i2.287

Keywords:

perforated appendicitis, hyponatremia, leukocytosis, predictive value

Abstract

Acute appendicitis is a surgical emergency that is often found in children with higher perforation rates at a younger age. Several examinations have been put forward as predictors of the incidence of appendix perforation. The purpose of this study was to determine the role of sodium and leukocytes as predictors of perforated appendicitis in children at RSUP Dr. M. Djamil, Padang.  This type of research is analytical with a cross-sectional study design. The study was conducted from August to October 2022 at RSUP Dr. M. Djamil Padang. The sample was taken by consecutive sampling with criteria aged 0-18 years and diagnosed with acute appendicitis at RSUP Dr. M. Djamil. In this study, a sample of 112 people with perforation occurred in 67 samples (60%). In the perforation group, most patients (55%) aged 6-11 years were male (67%), had hyponatremia laboratory results (91%) and leukocytosis laboratory results (86.5%) and underwent laparotomy procedures (57.2%). From the SPSS results, a significant difference was obtained between the incidence of hyponatremia in perforated and non-perforated appendicitis with a p-value of <0.001. The limit of the predictive value of sodium is ?134.5 mmol / L. Leukocytes were also found to be associated with perforated appendicitis with a p-value of <0.001 The limit of the predictive value of leukocytes is ? 14,025 cells / mm3.  There was a significant association between sodium and leukocyte levels and perforation incidence with predictive value limits of ?134.5 mmol/L and ? 14,025 cells/mm3, respectively.

References

Alhamda, S., Efendi, J., & Arnofyan, B. P. (2022). Sodium Levels as a Predicting Factor for the Occurrence of Perforated Appendicitis in Children at Dr. M. Djamil General Hospital Padang. Bioscientia Medicina: Journal of Biomedicine and Translational Research, 6(9), 2154–2158.

Almaramhy, H. H. (2017). Acute appendicitis in young children less than 5 years: review article. In Italian Journal of Pediatrics (Vol. 43). https://doi.org/10.1186/s13052-017-0335-2

Anand, S., Krishnan, N., Birley, J. R., Tintor, G., Bajpai, M., & Pogoreli?, Z. (2022). Hyponatremia—A New Diagnostic Marker for Complicated Acute Appendicitis in Children: A Systematic Review and Meta-Analysis. Children, 9(7), 1070.

Araim, F., Shmelev, A., & Kowdley, G. C. (2022). Incidence of Complicated Appendicitis as a Metric of Health Care Delivery. American Surgeon, 88(4). https://doi.org/10.1177/0003134820953769

Augustin, T., Cagir, B., & VanderMeer, T. J. (2011). Characteristics of Perforated Appendicitis: Effect of Delay Is Confounded by Age and Gender. Journal of Gastrointestinal Surgery, 15(7). https://doi.org/10.1007/s11605-011-1486-x

Beltrán, M. A., Almonacid, J., Vicencio, A., Gutiérrez, J., Cruces, K. S., & Cumsille, M. A. (2007). Predictive value of white blood cell count and C-reactive protein in children with appendicitis. Journal of Pediatric Surgery, 42(7). https://doi.org/10.1016/j.jpedsurg.2007.02.010

Chandrashekar, S., Lokesh, M. G., & Avinash, S. R. (2018). Prevalence of perforated appendicitis and its determinants in pediatric appendicitis patients admitted in tertiary care centre, South India: a cross sectional study. International Surgery Journal, 5(12). https://doi.org/10.18203/2349-2902.isj20185020

Dickinson, C. M., Coppersmith, N. A., & Luks, F. I. (2017). Early Predictors of Abscess Development after Perforated Pediatric Appendicitis. Surgical Infections, 18(8). https://doi.org/10.1089/sur.2017.134

Duman, L., Karaibrahimo?lu, A., Büyükyavuz, B. I., & Sava?, M. Ç. (2022). Diagnostic value of monocyte-to-lymphocyte ratio against other biomarkers in children with appendicitis. Pediatric Emergency Care, 38(2). https://doi.org/10.1097/PEC.0000000000002347

Farné, G. M., Lauro, A., Vaccari, S., Marino, I. R., Khouzam, S., D’Andrea, V., Cervellera, M., & Tonini, V. (2021). Spontaneous Perforated Duodenal Diverticulum: Wait or Cut First? Digestive Diseases and Sciences, 66(9). https://doi.org/10.1007/s10620-021-07092-1

Gray, D. T., & Mizrahi, T. (2020). Trends in Appendicitis and Perforated Appendicitis Prevalence in Children in the United States, 2001-2015. In JAMA Network Open (Vol. 3, Issue 10). https://doi.org/10.1001/jamanetworkopen.2020.23484

Guss, D. A., & Richards, C. (2000). Comparison of men and women presenting to an ED with acute appendicitis. American Journal of Emergency Medicine, 18(4). https://doi.org/10.1053/ajem.2000.7323

Howell, E. C., Dubina, E. D., & Lee, S. L. (2018). Perforation risk in pediatric appendicitis: Assessment and management. In Infection and Drug Resistance (Vol. 11). https://doi.org/10.2147/IDR.S167639

Jones, M. W., Lopez, R. A., & Deppen, J. G. (2021). Appendicitis. In StatPearls [Internet]. StatPearls Publishing.

Jung, S. K., Rhee, D. Y., Lee, W. J., Woo, S. H., Seol, S. H., Kim, D. H., & Choi, S. P. (2017). Neutrophil-to-lymphocyte count ratio is associated with perforated appendicitis in elderly patients of emergency department. Aging Clinical and Experimental Research, 29(3). https://doi.org/10.1007/s40520-016-0584-8

Kim, T. H., Cho, B. S., Jung, J. H., Lee, M. S., Jang, J. H., & Kim, C. N. (2015). Predictive factors to distinguish between patients with noncomplicated appendicitis and those with complicated appendicitis. Annals of Coloproctology, 31(5). https://doi.org/10.3393/ac.2015.31.5.192

Lesmana, G. P., Rudiman, R., & Septrina, R. (2020). Accuracy of D-Dimer Levels and C-reactive Protein in Predicting Perforation of Acute Appendicitis. Jurnal Llmu Bedah Indonesia, 48(1). https://doi.org/10.46800/jibi-ikabi.v48i1.57

Lindestam, U., Almström, M., Jacks, J., Malmquist, P., Lönnqvist, P. A., Jensen, B. L., Carlström, M., Krmar, R. T., Svensson, J. F., Norberg, Å., & Fläring, U. (2020). Low Plasma Sodium Concentration Predicts Perforated Acute Appendicitis in Children: A Prospective Diagnostic Accuracy Study. In European Journal of Pediatric Surgery (Vol. 30, Issue 4). https://doi.org/10.1055/s-0039-1687870

Loha, M., Mulu, A., Abay, S. M., Ergete, W., & Geleta, B. (2019). Acute and Subacute Toxicity of Methanol Extract of Syzygium guineense Leaves on the Histology of the Liver and Kidney and Biochemical Compositions of Blood in Rats. Evidence-Based Complementary and Alternative Medicine, 2019. https://doi.org/10.1155/2019/5702159

Neogi, S., Banerjee, A., Panda, S. S., Ratan, S. K., & Narang, R. (2022). Laparoscopic versus open appendicectomy for complicated appendicitis in children: A systematic review and meta-analysis. In Journal of Pediatric Surgery (Vol. 57, Issue 3). https://doi.org/10.1016/j.jpedsurg.2021.07.005

Pham, X. B. D., Sullins, V. F., Kim, D. Y., Range, B., Kaji, A. H., de Virgilio, C. M., & Lee, S. L. (2016). Factors predictive of complicated appendicitis in children. Journal of Surgical Research, 206(1). https://doi.org/10.1016/j.jss.2016.07.023

Pogoreli?, Z., Lukši?, B., Nin?evi?, S., Lukši?, B., & Polašek, O. (2021). Hyponatremia as a predictor of perforated acute appendicitis in pediatric population: A prospective study. Journal of Pediatric Surgery, 56(10). https://doi.org/10.1016/j.jpedsurg.2020.09.066

Sahbaz, N. A., Bat, O., Kaya, B., Ulukent, S. C., Ilkgul, O., Ozgun, M. Y., & Akca, O. (2014). The clinical value of leucocyte count and neutrophil percentage in diagnosing uncomplicated (simple) appendicitis and predicting complicated appendicitis. Turkish Journal of Trauma and Emergency Surgery, 20(6). https://doi.org/10.5505/tjtes.2014.75044

Sheen, J., Bowen, J., Whitmore, H., & Bowling, K. (2022). Hyponatremia as a Marker of Complicated Appendicitis: A Retrospective Analysis. Cureus, 14(7).

Turhan, V. B., Unsal, A., Öztürk, B., Ozturk, D., & Bulus, H. (2022). Predictive value of serum sodium level in determining perforated appendicitis. Ulusal Travma ve Acil Cerrahi Dergisi, 28(3). https://doi.org/10.14744/tjtes.2021.69670

Yamazaki, S., Shimodaira, Y., Kobayashi, A., Takata, M., Hayashibara, K., Sakon, M., Sekino, Y., Okada, M., Takahashi, Y., Shimura, M., Seki, H., & Soejima, Y. (2021). Predictive factors of perforated appendicitis: Impact of the C-reactive protein level. Surgery Open Science, 6. https://doi.org/10.1016/j.sopen.2021.06.003

Yang, J., Liu, C., He, Y., & Cai, Z. (2019). Laboratory Markers in the Prediction of Acute Perforated Appendicitis in Children. Emergency Medicine International, 2019. https://doi.org/10.1155/2019/4608053

Zhou, H., Lapointe, B. M., Clark, S. R., Zbytnuik, L., & Kubes, P. (2006). A Requirement for Microglial TLR4 in Leukocyte Recruitment into Brain in Response to Lipopolysaccharide. The Journal of Immunology, 177(11). https://doi.org/10.4049/jimmunol.177.11.8103

Zvizdic, Z., Golos, A. D., Milisic, E., Jonuzi, A., Zvizdic, D., Glamoclija, U., & Vranic, S. (2021). The predictors of perforated appendicitis in the pediatric emergency department: A retrospective observational cohort study. American Journal of Emergency Medicine, 49. https://doi.org/10.1016/j.ajem.2021.06.028

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Published

2022-11-24