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Year : 2020  |  Volume : 53  |  Issue : 4  |  Page : 123-127

Are immature granulocytes and derivatives early predictors of acute appendicitis and acute complicated appendicitis in adults?

Department of Emergency Medicine, Antalya Training and Research Hospital, Health Science University, Antalya, Turkey

Correspondence Address:
Cihan Bedel
Department of Emergency Medicine, Antalya Training and Research Hospital, Health Science University, Kazim Karabekir Street, Muratpasa, Antalya
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/fjs.fjs_111_19

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Background: The aim of this study was to investigate the usability of immature granulocyte count (IGC), immature granulocyte percentage (IG%), and IGC to neutrophil ratio (IGC/N ratio), a new inflammatory marker, in both diagnosing acute appendicitis (AA) and differentiation of simple and complicated appendicitis (SA and CA). Materials and Methods: This study was conducted on 262 adult patients who underwent appendectomy. The patients were histopathologically divided into positive and negative appendectomy groups. The patients in the AA group were also divided into SA and CA subgroups. The demographic and laboratory data of the patients were compared. Results: The mean values of white blood cell count, neutrophil-to-lymphocyte ratio, IGC, IG%, IGC/N, and C-reactive protein (CRP) are the parameters that can be used both to diagnose AA and to differentiate CA from SA. In our study, the ability of IGC to predict AA was found to be greater than that of other parameters. For IGC, the area under the receiver operating characteristic curve (AUC) was 0.784, the sensitivity was 98.3% and the specificity was 80%. CRP and IGC/N ratio had the highest specificity predictive values in differentiating CA from SA. For IGC/N, the AUC was 0.702, the sensitivity was 63.9%, and the specificity was 72.3%. Conclusion: IGC is a reliable inflammatory marker in the diagnosis of AA but immature granulocytes and derivatives (IGC, IG%, and IGC/N) cannot be used for predicting CA because of low sensitivity and specificity.

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