Systemic inflammatory indices and age-dependent severity in acute appendicitis: a retrospective cohort study
BackgroundAcute appendicitis (AA) remains the most common cause of emergency abdominal surgery, yet achieving precise preoperative risk stratification is still challenging, particularly among elderly patients. Recent interest has focused on systemic inflammatory biomarkers and the role of immunosene...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1620459/full |
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| author | Catalin Vladut Ionut Feier Catalin Vladut Ionut Feier Andrei Motoc Calin Muntean Razvan Constantin Vonica Razvan Constantin Vonica Vasile Gaborean Vasile Gaborean Sorin Olariu Sorin Olariu Marius Sorin Murariu Marius Sorin Murariu |
| author_facet | Catalin Vladut Ionut Feier Catalin Vladut Ionut Feier Andrei Motoc Calin Muntean Razvan Constantin Vonica Razvan Constantin Vonica Vasile Gaborean Vasile Gaborean Sorin Olariu Sorin Olariu Marius Sorin Murariu Marius Sorin Murariu |
| author_sort | Catalin Vladut Ionut Feier |
| collection | DOAJ |
| description | BackgroundAcute appendicitis (AA) remains the most common cause of emergency abdominal surgery, yet achieving precise preoperative risk stratification is still challenging, particularly among elderly patients. Recent interest has focused on systemic inflammatory biomarkers and the role of immunosenescence in influencing disease progression.Materials and methodsWe retrospectively analyzed 407 adult patients who underwent appendectomy over a six-year period at a tertiary hospital. Patients were grouped by age and histopathological subtype. Preoperative blood counts were used to calculate systemic inflammatory indices, including NLR, PLR, SII, SIRI, and AISI. Associations between biomarkers and histopathological severity were assessed using multivariable multinomial logistic regression, with adjustments for age and hospitalization duration.ResultsHigher neutrophil counts and elevated PLR were significantly associated with gangrenous appendicitis (p < 0.001 and p = 0.047, respectively). Increased SIRI and neutrophil levels predicted phlegmonous appendicitis (p = 0.020 and p < 0.001). Age independently correlated with more severe histopathological forms. Distinct variations in inflammatory profiles were observed across different age groups and histological categories.ConclusionSystemic inflammatory indices, particularly NLR, PLR, SII, and SIRI, hold considerable promise for enhancing preoperative stratification in acute appendicitis. Their integration into clinical practice could improve diagnostic accuracy, especially in older patients affected by immunosenescence. |
| format | Article |
| id | doaj-art-bfcabc5dacd14aaeb8811cbbe9050e41 |
| institution | DOAJ |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-bfcabc5dacd14aaeb8811cbbe9050e412025-08-20T03:12:30ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-07-011610.3389/fimmu.2025.16204591620459Systemic inflammatory indices and age-dependent severity in acute appendicitis: a retrospective cohort studyCatalin Vladut Ionut Feier0Catalin Vladut Ionut Feier1Andrei Motoc2Calin Muntean3Razvan Constantin Vonica4Razvan Constantin Vonica5Vasile Gaborean6Vasile Gaborean7Sorin Olariu8Sorin Olariu9Marius Sorin Murariu10Marius Sorin Murariu11Abdominal Surgery and Phlebology Research Center, Victor Babeş University of Medicine and Pharmacy, Timisoara, RomaniaFirst Surgery Clinic, “Pius Brinzeu” Clinical Emergency Hospital, Timişoara, RomaniaDepartment of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Timisoara, RomaniaMedical Informatics and Biostatistics, Department III-Functional Sciences, “Victor Babeş” University of Medicine and Pharmacy Timişoara, Timişoara, RomaniaPreclinical Department, Discipline of Physiology, Faculty of Medicine, “Lucian Blaga” University of Sibiu, Sibiu, RomaniaDepartment of Oncology, Elysee Hospital, Alba Iulia, RomaniaThoracic Surgery Research Center, “Victor Babeş” University of Medicine and Pharmacy Timişoara, Timişoara, RomaniaDepartment of Surgical Semiology, Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy Timişoara, Timişoara, RomaniaAbdominal Surgery and Phlebology Research Center, Victor Babeş University of Medicine and Pharmacy, Timisoara, RomaniaFirst Surgery Clinic, “Pius Brinzeu” Clinical Emergency Hospital, Timişoara, RomaniaAbdominal Surgery and Phlebology Research Center, Victor Babeş University of Medicine and Pharmacy, Timisoara, RomaniaFirst Surgery Clinic, “Pius Brinzeu” Clinical Emergency Hospital, Timişoara, RomaniaBackgroundAcute appendicitis (AA) remains the most common cause of emergency abdominal surgery, yet achieving precise preoperative risk stratification is still challenging, particularly among elderly patients. Recent interest has focused on systemic inflammatory biomarkers and the role of immunosenescence in influencing disease progression.Materials and methodsWe retrospectively analyzed 407 adult patients who underwent appendectomy over a six-year period at a tertiary hospital. Patients were grouped by age and histopathological subtype. Preoperative blood counts were used to calculate systemic inflammatory indices, including NLR, PLR, SII, SIRI, and AISI. Associations between biomarkers and histopathological severity were assessed using multivariable multinomial logistic regression, with adjustments for age and hospitalization duration.ResultsHigher neutrophil counts and elevated PLR were significantly associated with gangrenous appendicitis (p < 0.001 and p = 0.047, respectively). Increased SIRI and neutrophil levels predicted phlegmonous appendicitis (p = 0.020 and p < 0.001). Age independently correlated with more severe histopathological forms. Distinct variations in inflammatory profiles were observed across different age groups and histological categories.ConclusionSystemic inflammatory indices, particularly NLR, PLR, SII, and SIRI, hold considerable promise for enhancing preoperative stratification in acute appendicitis. Their integration into clinical practice could improve diagnostic accuracy, especially in older patients affected by immunosenescence.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1620459/fullacute appendicitissystemic inflammatory biomarkersimmunosenescencesystemic immune-inflammation indexplatelet-to-lymphocyte ratio |
| spellingShingle | Catalin Vladut Ionut Feier Catalin Vladut Ionut Feier Andrei Motoc Calin Muntean Razvan Constantin Vonica Razvan Constantin Vonica Vasile Gaborean Vasile Gaborean Sorin Olariu Sorin Olariu Marius Sorin Murariu Marius Sorin Murariu Systemic inflammatory indices and age-dependent severity in acute appendicitis: a retrospective cohort study Frontiers in Immunology acute appendicitis systemic inflammatory biomarkers immunosenescence systemic immune-inflammation index platelet-to-lymphocyte ratio |
| title | Systemic inflammatory indices and age-dependent severity in acute appendicitis: a retrospective cohort study |
| title_full | Systemic inflammatory indices and age-dependent severity in acute appendicitis: a retrospective cohort study |
| title_fullStr | Systemic inflammatory indices and age-dependent severity in acute appendicitis: a retrospective cohort study |
| title_full_unstemmed | Systemic inflammatory indices and age-dependent severity in acute appendicitis: a retrospective cohort study |
| title_short | Systemic inflammatory indices and age-dependent severity in acute appendicitis: a retrospective cohort study |
| title_sort | systemic inflammatory indices and age dependent severity in acute appendicitis a retrospective cohort study |
| topic | acute appendicitis systemic inflammatory biomarkers immunosenescence systemic immune-inflammation index platelet-to-lymphocyte ratio |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1620459/full |
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