Case Control Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2015; 21(6): 1821-1826
Published online Feb 14, 2015. doi: 10.3748/wjg.v21.i6.1821
New parameter in diagnosis of acute appendicitis: Platelet distribution width
Bulent Dinc, Alten Oskay, Selcan Enver Dinc, Bilge Bas, Sabri Tekin
Bulent Dinc, Department of General Surgery, Ataturk State Hospital, Antalya 07040, Turkey
Alten Oskay, Department of Emergency, Denizli State Hospital, Denizli 20010, Turkey
Selcan Enver Dinc, Department of Emergency, Isparta State Hospital, Isparta 32100, Turkey
Bilge Bas, Department of Gastroenterology, Ataturk State Hospital, Antalya 07040, Turkey
Sabri Tekin, Department of Surgery, Medical Park Hospitals, Antalya 07160, Turkey
Author contributions: Dinc B and Oskay A planned the study; Dinc B, Oskay A, Dinc SE, and Tekin S collected the data; Dinc B performed the data analysis; Dinc B and Bas B interpreted the data; Dinc B and Dinc SE wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Bulent Dinc, MD, Department of General Surgery, Ataturk State Hospital, Gulluk Street, Antalya 07040, Turkey. bulent1999@yahoo.com
Telephone: +90-242-3454550 Fax: +90-242-3343373
Received: July 10, 2014
Peer-review started: July 10, 2014
First decision: August 15, 2014
Revised: August 24, 2014
Accepted: October 14, 2014
Article in press: October 15, 2014
Published online: February 14, 2015
Processing time: 216 Days and 14.8 Hours
Abstract

AIM: To investigate the diagnostic accuracy of the mean platelet volume and platelet distribution width in acute appendicitis.

METHODS: This retrospective, case-controlled study compared 295 patients with acute appendicitis (Group I), 100 patients with other intra-abdominal infections (Group II), and 100 healthy individuals (Group III) between January 2012 and January 2013. The age, gender, and white blood cell count, neutrophil percentage, mean platelet volume, and platelet distribution width values from blood samples were compared among the groups. Statistical analyses were performed using SPSS for Windows 21.0 software. In addition, the sensitivity, specificity, positive and negative predictive values and likelihood ratios, and diagnostic accuracy were calculated.

RESULTS: The mean ages of patients were 29.9 ± 12.0 years for Group I, 31.5 ± 14.0 years for Group II, and 30.4 ± 13.0 years for Group III. Demographic features such as age and gender were not significantly different among the groups. White blood cell count, neutrophil percentage and platelet distribution width were significantly higher in Group I compared to groups II and III (P < 0.05). Diagnostically, the sensitivity, specificity and diagnostic accuracy were 73.1%, 94.0%, and 78% for white blood cell count, 70.0%, 96.0%, and 76.0% for neutrophil percentage, 29.5%, 49.0%, and 34.0% for mean platelet volume, and 97.1%, 93.0%, and 96.0% for platelet distribution width, respectively. The highest diagnostic accuracy detected was for platelet distribution width between Group I and Group III (P < 0.01).

CONCLUSION: Platelet distribution width analysis can be used for diagnosis of acute appendicitis without requiring additional tests, thus reducing the cost and loss of time.

Keywords: Appendicitis; Diagnosis; Platelet function test; Platelet distribution width

Core tip: The diagnosis of acute appendicitis can be difficult and confusing. A rapid and accurate diagnosis is important because of potential complications, therefore, new biomarkers for diagnosis are needed. This study investigated the diagnostic accuracy of indicators of platelet activation, namely mean platelet volume and platelet distribution width, in acute appendicitis patients. Results shows that platelet distribution width analysis can be used for diagnosis of acute appendicitis without requiring additional tests. Therefore, it reduces the cost and loss of time.