The value of inflammatory indices in the diagnosis of acute appendicitis and prediction of complicated appendicitis: a retrospective study

Background Acute appendicitis is a common cause of acute abdominal pain, typically treated surgically, although medical management is also an option. Laboratory investigations play a valuable role in diagnosis and predicting prognosis. We aimed to investigate and compare the effectiveness of indices...

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Main Authors: Akif Yarkaç, Çiğdem Öncü Güldür, Seyran Bozkurt, Ataman Köse, Çağrı Safa Buyurgan, Semra Erdoğan, Tuba Kara
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Language:English
Published: PeerJ Inc. 2025-07-01
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Online Access:https://peerj.com/articles/19754.pdf
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author Akif Yarkaç
Çiğdem Öncü Güldür
Seyran Bozkurt
Ataman Köse
Çağrı Safa Buyurgan
Semra Erdoğan
Tuba Kara
author_facet Akif Yarkaç
Çiğdem Öncü Güldür
Seyran Bozkurt
Ataman Köse
Çağrı Safa Buyurgan
Semra Erdoğan
Tuba Kara
author_sort Akif Yarkaç
collection DOAJ
description Background Acute appendicitis is a common cause of acute abdominal pain, typically treated surgically, although medical management is also an option. Laboratory investigations play a valuable role in diagnosis and predicting prognosis. We aimed to investigate and compare the effectiveness of indices such as the Systemic Immune-Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI), and Pan-Immune-Inflammatory Value (PIV), all derived from complete blood count, in diagnosing acute appendicitis and distinguishing between complicated and uncomplicated cases. Methods We retrospectively analyzed data from 334 patients diagnosed with acute appendicitis and 350 healthy individuals. The SII, SIRI, and PIV parameters were compared between the acute appendicitis group and the healthy group. The SII, SIRI, and PIV parameters were also compared between the complicated and uncomplicated groups. Results All three parameters demonstrated good performance in predicting the diagnosis of appendicitis. An SII value above 1,008.43 (p < 0.0001, AUC = 0.707), a SIRI value above 2.60 (p < 0.0001, AUC = 0.743), and a PIV value above 904.85 (p < 0.0001, AUC = 0.726) were found to support the diagnosis of appendicitis. For predicting complicated appendicitis, thresholds were identified as SII values above 2501.13 (p = 0.0012, AUC = 0.634), SIRI values above 7.98 (p = 0.0005, AUC = 0.645), and PIV values above 1,869.66 (p = 0.0012, AUC = 0.635). Conclusions All three indices showed good predictive performance for diagnosing appendicitis and acceptable performance for predicting complicated cases. Among the indices, SIRI was slightly superior to the other two in both scenarios.
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spelling doaj-art-cecb81eae5be4d50b27f1272e18951512025-08-20T03:35:47ZengPeerJ Inc.PeerJ2167-83592025-07-0113e1975410.7717/peerj.19754The value of inflammatory indices in the diagnosis of acute appendicitis and prediction of complicated appendicitis: a retrospective studyAkif Yarkaç0Çiğdem Öncü Güldür1Seyran Bozkurt2Ataman Köse3Çağrı Safa Buyurgan4Semra Erdoğan5Tuba Kara6Department of Emergency Medicine, Mersin University, Mersin, TurkeyDepartment of Emergency Medicine, Mersin University, Mersin, TurkeyDepartment of Emergency Medicine, Mersin University, Mersin, TurkeyDepartment of Emergency Medicine, Mersin University, Mersin, TurkeyDepartment of Emergency Medicine, Mersin University, Mersin, TurkeyDepartment of Bioistatistics and Medical Informatics, Mersin University, Mersin, TurkeyDepartment of Pathology, Mersin University, Mersin, TurkeyBackground Acute appendicitis is a common cause of acute abdominal pain, typically treated surgically, although medical management is also an option. Laboratory investigations play a valuable role in diagnosis and predicting prognosis. We aimed to investigate and compare the effectiveness of indices such as the Systemic Immune-Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI), and Pan-Immune-Inflammatory Value (PIV), all derived from complete blood count, in diagnosing acute appendicitis and distinguishing between complicated and uncomplicated cases. Methods We retrospectively analyzed data from 334 patients diagnosed with acute appendicitis and 350 healthy individuals. The SII, SIRI, and PIV parameters were compared between the acute appendicitis group and the healthy group. The SII, SIRI, and PIV parameters were also compared between the complicated and uncomplicated groups. Results All three parameters demonstrated good performance in predicting the diagnosis of appendicitis. An SII value above 1,008.43 (p < 0.0001, AUC = 0.707), a SIRI value above 2.60 (p < 0.0001, AUC = 0.743), and a PIV value above 904.85 (p < 0.0001, AUC = 0.726) were found to support the diagnosis of appendicitis. For predicting complicated appendicitis, thresholds were identified as SII values above 2501.13 (p = 0.0012, AUC = 0.634), SIRI values above 7.98 (p = 0.0005, AUC = 0.645), and PIV values above 1,869.66 (p = 0.0012, AUC = 0.635). Conclusions All three indices showed good predictive performance for diagnosing appendicitis and acceptable performance for predicting complicated cases. Among the indices, SIRI was slightly superior to the other two in both scenarios.https://peerj.com/articles/19754.pdfAcute appendicitisComplicated appendicitisSystemic immune-inflammatory indexSystemic inflammation response indexPan-immune-inflammatory value
spellingShingle Akif Yarkaç
Çiğdem Öncü Güldür
Seyran Bozkurt
Ataman Köse
Çağrı Safa Buyurgan
Semra Erdoğan
Tuba Kara
The value of inflammatory indices in the diagnosis of acute appendicitis and prediction of complicated appendicitis: a retrospective study
PeerJ
Acute appendicitis
Complicated appendicitis
Systemic immune-inflammatory index
Systemic inflammation response index
Pan-immune-inflammatory value
title The value of inflammatory indices in the diagnosis of acute appendicitis and prediction of complicated appendicitis: a retrospective study
title_full The value of inflammatory indices in the diagnosis of acute appendicitis and prediction of complicated appendicitis: a retrospective study
title_fullStr The value of inflammatory indices in the diagnosis of acute appendicitis and prediction of complicated appendicitis: a retrospective study
title_full_unstemmed The value of inflammatory indices in the diagnosis of acute appendicitis and prediction of complicated appendicitis: a retrospective study
title_short The value of inflammatory indices in the diagnosis of acute appendicitis and prediction of complicated appendicitis: a retrospective study
title_sort value of inflammatory indices in the diagnosis of acute appendicitis and prediction of complicated appendicitis a retrospective study
topic Acute appendicitis
Complicated appendicitis
Systemic immune-inflammatory index
Systemic inflammation response index
Pan-immune-inflammatory value
url https://peerj.com/articles/19754.pdf
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