Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2024; 16(8): 2565-2573
Published online Aug 27, 2024. doi: 10.4240/wjgs.v16.i8.2565
Systemic immune-inflammation index combined with pediatric appendicitis score in assessing the severity and prognosis for paediatric appendicitis
Li-Ming Guo, Zhi-Hui Jiang, Hong-Zhen Liu
Li-Ming Guo, Zhi-Hui Jiang, Department of General Surgery, Qingdao Women and Children’s Hospital, Qingdao 266000, Shandong Province, China
Hong-Zhen Liu, Department of Pediatric Surgery, Children's Hospital Affiliated to Shandong University, Jinan 250022, Shandong Province, China
Hong-Zhen Liu, Department of Pediatric Surgery, Jinan Children's Hospital, Jinan 250022, Shandong Province, China
Co-first authors: Li-Ming Guo and Zhi-Hui Jiang.
Author contributions: Guo LM and Jiang ZH are co-first authors and contributed equally to this work, including design of the study, acquiring and analyzing data from experiments, and writing of the manuscript; Guo LM, Jiang ZH and Liu HZ designed the experiments and conducted clinical data collection; Guo LM and Jiang ZH performed postoperative follow-up and recorded the data, conducted the collation and statistical analysis, and wrote the original manuscript and revised the paper; all authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Qingdao Women and Children’s Hospital.
Informed consent statement: The Ethics Committee has agreed to waive informed consent.
Conflict-of-interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Ming Guo, MM, Department of General Surgery, Qingdao Women and Children’s Hospital, No. 6 Tongfu Road, Shibei District, Qingdao 266000, Shandong Province, China. guolimingqdfe@163.com
Received: May 10, 2024
Revised: July 2, 2024
Accepted: July 4, 2024
Published online: August 27, 2024
Processing time: 97 Days and 22 Hours
Abstract
BACKGROUND

Pediatric appendicitis is a common cause of abdominal pain in children and is recognized as a significant surgical emergency. A prompt and accurate diagnosis is essential to prevent complications such as perforation and peritonitis.

AIM

To investigate the predictive value of the systemic immune-inflammation index (SII) combined with the pediatric appendicitis score (PAS) for the assessment of disease severity and surgical outcomes in children aged 5 years and older with appendicitis.

METHODS

Clinical data of 104 children diagnosed with acute appendicitis were analyzed. The participants were categorized into the acute appendicitis group and chronic appendicitis group based on disease presentation and further stratified into the good prognosis group and poor prognosis group based on prognosis. The SII and PAS were measured, and a joint model using the combined SII and PAS was constructed to predict disease severity and surgical outcomes.

RESULTS

Significant differences were observed in the SII and PAS parameters between the acute appendicitis group and chronic appendicitis group. Correlation analysis showed associations among the SII, PAS, and disease severity, with the combined SII and PAS model demonstrating significant predictive value for assessing disease severity [aera under the curve (AUC) = 0.914] and predicting surgical outcomes (AUC = 0.857) in children aged 5 years and older with appendicitis.

CONCLUSION

The study findings support the potential of integrating the SII with the PAS for assessing disease severity and predicting surgical outcomes in pediatric appendicitis, indicating the clinical utility of the combined SII and PAS model in guiding clinical decision-making and optimizing surgical management strategies for pediatric patients with appendicitis.

Keywords: Systemic immune-inflammation index; Pediatric appendicitis score; Disease severity; Surgical outcomes; Risk factor; Logistic regression; Receiver operating characteristic analysis

Core Tip: This study investigates the combined use of the Systemic Immune-inflammation index (SII) and pediatric appendicitis score (PAS) to predict disease severity and surgical outcomes in children aged 5 years and older with appendicitis. The results demonstrate significant improvements in clinical decision-making and prognosis assessment. Integrating SII and PAS provides a comprehensive assessment of the systemic inflammatory response and clinical symptoms, offering a novel and effective approach to managing pediatric appendicitis.