Abstract

PurposeThe aim of this study was to seek whether red cell distribution width (RDW) has a role in the diagnosis of acute appendicitis. It was also aimed to show the relationship of RDW with leukocyte count and C-reactive protein (CRP) level.MethodsThis study was conducted via retrospective assessment of the hospital records of the adult patients who were operated for acute appendicitis between January 2010 and February 2013 and had a pathology report that confirmed the diagnosis of acute appendicitis. The patients in the control group were selected from healthy adults of similar age who applied to check-up clinic. Age, gender, leukocyte count, CRP, and RDW values were recorded. This study is a case controlled retrospective clinical study.ResultsA total of 590 patients in the acute appendicitis group and 121 patients in the control group were included, making up a total of 711 subjects. The mean RDW levels were 15.4 ± 1.5% in the acute appendicitis group, while 15.9 ± 1.4% in the control group. CRP, leukocyte count were significantly higher in the acute appendicitis group, and RDW level were significantly lower in the acute appendicitis group (p < 0.001, p < 0.001, p = 0.001, respectively). RDW, leukocyte count, and CRP had a sensitivity and specificity of 47% and 67%; 91% and 74%; and 97% and 41%, respectively in acute appendicitis. RDW was not correlated with CRP and leukocyte levels. However, we found a correlation between CRP and leukocyte levels.ConclusionRDW level was lower in patients with acute appendicitis. The magnitude of difference in RDW seen between acute appendicitis and controls was so slight as to be of no utility in diagnostic testing.

Highlights

  • Acute appendicitis (AA) is the most common surgical abdominal emergency [1]

  • A total of 590 patients were included in the AA group and 121 patients were included in the control group, making up a total of 711 subjects

  • red cell distribution width (RDW) level was significantly lower in the AA group compared with the control group (p = 0.001) (Table 1)

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Summary

Introduction

Because increased time between onset of symptoms and surgical intervention is associated with increased risk of appendiceal perforation and potential peritonitis, sepsis, and death [2]. It has been reported that RDW level has clinical implications in various pathologies such as inflammatory bowel disease, celiac disease, pulmonary embolism, and coronary artery disease [6,7,8,9,10]. Its predictive role has been shown in inflammatory and infectious pathological diseases including acute pancreatitis, bacteremia, sepsis, and septic shock [11,12,13]. In the present study we aimed to seek whether RDW level is important in the diagnosis of AA. It was aimed to show the relationship of RDW level with leukocyte count and CRP level

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