A new predictive factor for complicated appendicitis: Hyponatremia
Mehmet Akif Ustuner1, Abdulkadir Deniz11Deparmant of Gastroenterolojic Surgery, University of Health Sciences Gülhane Training and Research Hospital, Ankara, Turkey
Objectives: Acute appendicitis is the most common abdominal surgical procedure, which is associated with a high risk of perforation. Perforation may lead to intraabdominal abscess and sepsis, resulting in complicated appendicitis. The present study investigated whether hyponatremia could be a predictive factor for complicated appendicitis. Methods: The study included 295 patients operated due to acute appendicitis, and retrospectively evaluated operation records, pathology results, serum levels of Na, CRP, WBC count, neutrophil count, lymphocyte count and NLR (neutrophil/lymphocyte) values. Patients were divided into two groups as complicated appendicitis (Group 1) and non-complicated appendicitis (Group 2) for comparison. The normal range of sodium was accepted as 135–145 mEq/l. Results: The mean age of the patients was 33.77 (18–82) years and there were 188 (63.72%) male and 107 (36.27%) female. The mean age was 40 years and 28 years in Group 1 and Group 2, respectively (p<0.01). The ratio of females was 47% (n:31) in Group 1, and 33.2% (n:76) in Group 2 (p: 0.04). The mean CRP value was 113.72 mg/dl in Group 1 and 12.56 mg/dl in Group 2 (p<0.01). The mean percentage of lymphocytes was 12.20 in Group 1 and 14.40 in Group 2 (p: 0.049). The mean sodium value was 133 mEq/l in Group 1 and 138 mEq/l in Group 2 (p<0.01). The cut-off value for sodium was found to be 134 mEq/l (sensitivity: 78.79%; specificity: 93.01%; AUC: 0.903). Conclusion: The levels of sodium, CRP and lymphocytes were found to be predictive of complicated appendicitis. The cut-off value for sodium was found to be 134 mEq/l, with high sensitivity and specificity. Keywords: acute appendicitis, complicated appendicitis, sodium, hyponatremia
Cite This Article
Ustuner M, Deniz A. A new predictive factor for complicated appendicitis: Hyponatremia. EJMI. 2020; 4(3): 401-404
Corresponding Author: Mehmet Akif Ustuner