Comparison of the ability of newly inflammatory markers to predict complicated appendicitis.

Introduction: Acute appendicitis (AA) is the predominant condition responsible for acute abdominal pain across all age demographics. The purpose of this research is to determine if the hemoglobin, albumin, lymphocyte, and platelet (HALP) and modified HALP (m-HALP) scores differ between complicated and uncomplicated appendicitis in patients diagnosed with AA who have applied to the emergency department (ED). Additionally, this study aims to investigate whether HALP and m-HALP scores are superior to other biomarkers. Materials and methods: The retrospective analysis included adult patients, aged eighteen or older, who were diagnosed with AA, and sought treatment at the ED of a tertiary hospital. Patients were divided into two groups: complicated appendicitis (CA) and uncomplicated appendicitis (UCA). The cut-off in diagnostic value measurements was determined using the receiver operating characteristic analysis. Results: A total of 436 patients (CA: 126, UCA: 310) were included. Neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-albumin ratio, systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune inflammation value (PIV) were found to have acceptable diagnostic power in CA detection (area under the curve [AUC]: 0.735-0.783). In detecting UCA, HALP and m-HALP were of fair diagnostic power (AUC: 0.64, 0.68, respectively). Conclusions: In this study, we found that although PIV, SIRI, SII, and NLR had acceptable diagnostic values in distinguishing CA and UCA, HALP and m-HALP had fair diagnostic values.

Evaluation of inflammatory biomarkers affecting mortality in acute cholecystitis in the emergency department.

OBJECTIVES: The aim of this study was to investigate the effectiveness of pan-immune inflammation value (PIV), systemic immune-inflammatory index (SII), and systemic inflammation response index (SIRI) in predicting mortality in acute cholecystitis (AC). BACKGROUND: Abdominal pain is one of the most frequent complaints encountered by physicians at emergency department (ED). METHODS: This clinical study is a cross-sectional study among patients admitted to the emergency department of a tertiary hospital and diagnosed with AC. Total survival curves were estimated by the Kaplan‒Meier method. Differences according to risk groups were determined by the log-rank test. RESULTS: A total of 789 patients (survival: 737, non-survival: 52) diagnosed with AC were enrolled in the study. NLR and SII had an excellent diagnostic power in predicting 30-day mortality in the receiver operating characteristic (ROC) analysis, while the diagnostic power of SIRI and PIV was acceptable. It was observed that the probability of survival period decreased in the presence of NLR (>11.07), SII (>2315.18), SIRI (>6.55), and PIV (>1581.13) above the cut-off levels. The HRs of NLR, SII, SIRI, and PIV were 10.52, 7.44, 6.34, and 5.6, respectively. CONCLUSION: NLR, SII, SIRI, and PIV may be useful markers in predicting 30-day mortality in patients with AC (Tab. 3, Fig. 5, Ref. 25).

Relation between partial arterial carbon dioxide pressure and pH value and optic nerve sheath diameter: a prospective self-controlled non-randomized trial study.

OBJECTIVE: This study aims to determine if there is a correlation between differences in optic nerve sheath diameter (ONSD) and changes in PaCO2 and pH values that were measured in the arterial blood gas (ABG) before and after treatment in COPD patients with acute hypercarbic respiratory failure (AHRF). MATERIALS AND METHODS: This study serves as a prospective self-controlled non-randomized trial study conducted in the emergency clinic of a tertiary hospital. Forty-four patients with COPD, who were found to have acidosis and hypercarbia in ABG and had an indication for non-invasive mechanic ventilation (NIMV), were analyzed prospectively. Demographic information, vital findings, initial ABG values, the ONSD measurement (before the NIMV treatment), consciousness state, and the ABG results obtained in the second hour of the monitoring and the ONSD measurement (after the NIMV treatment) were recorded. RESULTS: In this study, 13 (29.5%) of the patients were female and 31 (70.5%) were male. The age distribution was evaluated as 68.3 ± 9.2 years; the minimum age was 54 and the maximum was 91. A high level of positively significant correlation was found between the mean ONSD and PaCO2 (p < 0.0001). There is a high fit (0.72) between the mean ONSD and PaCO2. A moderate level of negatively significant correlation was found between the mean ONSD and the pH (p < 0.0001). However, there is an insignificant low fit (0.32) between the mean ONSD and the pH. CONCLUSION: The ONSD changed significantly and in a highly correlated manner to acute changes in PaCO2 levels.