Document Type : Original Article
Authors
1 Students Research Committee, MMS.C., Islamic Azad University, Mashhad, Iran.
2 Innovative Medical Research Center, MMS.C., Islamic Azad University, Mashhad, Iran.
3 Department of Emergency Medicine, Razavi Hospital, Mashhad, Iran.
4 Department of Community Medicine, MMS.C., Islamic Azad University, Mashhad, Iran.
5 Department of General Surgery, MMS.C., Islamic Azad University, Mashhad, Iran.
Abstract
Background: Acute appendicitis (AA) is a leading cause of acute abdominal pain. However, accurately
diagnosing AA remains challenging, as a definitive and reliable predictive method has not yet been established.
This study aimed to assess the potential of the Systemic Inflammatory Response Index (SIRI) for diagnosing
AA, its possible advantages over current methods, and its utility in distinguishing uncomplicated from
complicated appendicitis.
Methods: In this cross-sectional study, 240 patients scheduled for appendectomy with a diagnosis of AA were
enrolled. Demographic information, clinical and paraclinical findings, including complete blood count (CBC),
Alvarado score, SIRI, sonography findings, and pathology results, were documented. Data were analyzed using
SPSS software version 26.
Results: Of the 240 patients, 106 (44.2%) were men, and 134 (55.8%) were women, with a mean age of 37.49±15.55
years. Final pathology reports identified 26 (10.8%) cases of a normal appendix, 176 (73.3%) with uncomplicated
appendicitis, 23 (9.6%) with complicated appendicitis, and 15 (6.3%) with reactive lymphoid hyperplasia. SIRI
demonstrated significant differences across the pathology groups (P<0.0001). It showed notable discrimination
between normal and complicated appendicitis (P=0.005), normal and combined appendicitis (P=0.008), and
suggestive differences for normal versus uncomplicated (P=0.021) and uncomplicated versus complicated
cases (P=0.044). Similarly, Alvarado scores showed significant differences, particularly between the normal
and complicated appendicitis groups.
Conclusion: The SIRI and Alvarado scoring systems showed significant potential for diagnosing appendicitis
with acceptable sensitivity and specificity. They might also assist in differentiating between uncomplicated and
complicated appendicitis.
Keywords
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