The Role of Hyponatremia in Identifying Complicated Cases of Acute Appendicitis in the Pediatric Population

<b>Background</b>: Hyponatremia has been identified as a marker of disease severity in various inflammatory conditions. However, its role in predicting acute complicated appendicitis (ACA) in children remains under investigation. This study evaluated the association between preoperative...

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Main Authors: George Kottakis, Konstantina Bekiaridou, Stylianos Roupakias, Orestis Pavlides, Ioannis Gogoulis, Spyridon Kosteletos, Theodoros Nektarios Dionysis, Aggelos Marantos, Katerina Kambouri
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Language:English
Published: MDPI AG 2025-05-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/11/1384
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author George Kottakis
Konstantina Bekiaridou
Stylianos Roupakias
Orestis Pavlides
Ioannis Gogoulis
Spyridon Kosteletos
Theodoros Nektarios Dionysis
Aggelos Marantos
Katerina Kambouri
author_facet George Kottakis
Konstantina Bekiaridou
Stylianos Roupakias
Orestis Pavlides
Ioannis Gogoulis
Spyridon Kosteletos
Theodoros Nektarios Dionysis
Aggelos Marantos
Katerina Kambouri
author_sort George Kottakis
collection DOAJ
description <b>Background</b>: Hyponatremia has been identified as a marker of disease severity in various inflammatory conditions. However, its role in predicting acute complicated appendicitis (ACA) in children remains under investigation. This study evaluated the association between preoperative hyponatremia and ACA in a pediatric population. <b>Methods</b>: A retrospective study was conducted on pediatric patients treated for acute appendicitis in two major pediatric centers in Greece. Patients were categorized into groups based on the presence of acute uncomplicated appendicitis (AUA) and acute complicated appendicitis (ACA). Preoperative laboratory parameters were analyzed to identify potential predictors of ACA. <b>Results</b>: This study included 491 pediatric patients, with a mean age of 10 years. ACA patients exhibited significantly lower Na levels compared to those with AUA (136 vs. 138 mmol/L, <i>p</i> < 0.001). Hyponatremia (<135 mmol/L) was present in 38.4% of ACA cases compared to 2.2% of AUA cases (<i>p</i> < 0.001), and was associated with a significantly increased risk of ACA (OR = 18.30, <i>p</i> < 0.001). A sodium threshold of 135 mmol/L also demonstrated a sensitivity of 48% and a specificity of 92.1% <b>Conclusions</b>: Hyponatremia is a strong and specific predictor of ACA in children. When combined with other inflammatory markers, it may enhance early risk stratification, aiding in timely surgical decision making.
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spelling doaj-art-bafb90bea5db4673be1d1808633e05ce2025-08-20T03:46:52ZengMDPI AGDiagnostics2075-44182025-05-011511138410.3390/diagnostics15111384The Role of Hyponatremia in Identifying Complicated Cases of Acute Appendicitis in the Pediatric PopulationGeorge Kottakis0Konstantina Bekiaridou1Stylianos Roupakias2Orestis Pavlides3Ioannis Gogoulis4Spyridon Kosteletos5Theodoros Nektarios Dionysis6Aggelos Marantos7Katerina Kambouri8Pediatric Surgery Department, Elena Venizelou General Hospital, 115 21 Athens, GreecePediatric Surgery Department, University Hospital of Alexandroupolis, Democritus University of Thrace, 681 00 Alexandroupolis, GreecePediatric Surgery Department, University Hospital of Alexandroupolis, Democritus University of Thrace, 681 00 Alexandroupolis, Greece1st Pediatric Surgery Department, Panagiotis and Aglaia Kyriakou Children’s Hospital of Athens, 115 27 Athens, GreecePediatric Surgery Department, University Hospital of Alexandroupolis, Democritus University of Thrace, 681 00 Alexandroupolis, Greece1st Pediatric Surgery Department, Panagiotis and Aglaia Kyriakou Children’s Hospital of Athens, 115 27 Athens, Greece1st Pediatric Surgery Department, Panagiotis and Aglaia Kyriakou Children’s Hospital of Athens, 115 27 Athens, Greece1st Pediatric Surgery Department, Panagiotis and Aglaia Kyriakou Children’s Hospital of Athens, 115 27 Athens, GreecePediatric Surgery Department, University Hospital of Alexandroupolis, Democritus University of Thrace, 681 00 Alexandroupolis, Greece<b>Background</b>: Hyponatremia has been identified as a marker of disease severity in various inflammatory conditions. However, its role in predicting acute complicated appendicitis (ACA) in children remains under investigation. This study evaluated the association between preoperative hyponatremia and ACA in a pediatric population. <b>Methods</b>: A retrospective study was conducted on pediatric patients treated for acute appendicitis in two major pediatric centers in Greece. Patients were categorized into groups based on the presence of acute uncomplicated appendicitis (AUA) and acute complicated appendicitis (ACA). Preoperative laboratory parameters were analyzed to identify potential predictors of ACA. <b>Results</b>: This study included 491 pediatric patients, with a mean age of 10 years. ACA patients exhibited significantly lower Na levels compared to those with AUA (136 vs. 138 mmol/L, <i>p</i> < 0.001). Hyponatremia (<135 mmol/L) was present in 38.4% of ACA cases compared to 2.2% of AUA cases (<i>p</i> < 0.001), and was associated with a significantly increased risk of ACA (OR = 18.30, <i>p</i> < 0.001). A sodium threshold of 135 mmol/L also demonstrated a sensitivity of 48% and a specificity of 92.1% <b>Conclusions</b>: Hyponatremia is a strong and specific predictor of ACA in children. When combined with other inflammatory markers, it may enhance early risk stratification, aiding in timely surgical decision making.https://www.mdpi.com/2075-4418/15/11/1384hyponatremiaacute complicated appendicitispediatric surgery
spellingShingle George Kottakis
Konstantina Bekiaridou
Stylianos Roupakias
Orestis Pavlides
Ioannis Gogoulis
Spyridon Kosteletos
Theodoros Nektarios Dionysis
Aggelos Marantos
Katerina Kambouri
The Role of Hyponatremia in Identifying Complicated Cases of Acute Appendicitis in the Pediatric Population
Diagnostics
hyponatremia
acute complicated appendicitis
pediatric surgery
title The Role of Hyponatremia in Identifying Complicated Cases of Acute Appendicitis in the Pediatric Population
title_full The Role of Hyponatremia in Identifying Complicated Cases of Acute Appendicitis in the Pediatric Population
title_fullStr The Role of Hyponatremia in Identifying Complicated Cases of Acute Appendicitis in the Pediatric Population
title_full_unstemmed The Role of Hyponatremia in Identifying Complicated Cases of Acute Appendicitis in the Pediatric Population
title_short The Role of Hyponatremia in Identifying Complicated Cases of Acute Appendicitis in the Pediatric Population
title_sort role of hyponatremia in identifying complicated cases of acute appendicitis in the pediatric population
topic hyponatremia
acute complicated appendicitis
pediatric surgery
url https://www.mdpi.com/2075-4418/15/11/1384
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