Title
Komparativna analiza markera trombocita i markera inflamacije u dijagnostici akutnog apendicitisa kod odraslih
Creator
Dimić, Saša, 1973-
CONOR:
2157159
Copyright date
2023
Object Links
Select license
Autorstvo-Nekomercijalno-Bez prerade 3.0 Srbija (CC BY-NC-ND 3.0)
License description
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Language
Serbian
Cobiss-ID
Theses Type
Doktorska disertacija
description
Datum odbrane: 09.05.2023.
Other responsibilities
predsednik komisije
Đorđević, Nebojša
član komisije
Stojanović, Miroslav
član komisije
Stojanović, Goran
član komisije
Ivanov, Dejan
Academic Expertise
Medicinske nauke
University
Univerzitet u Nišu
Faculty
Medicinski fakultet
Group
Katedra za hirurgiju
Alternative title
Comparative analysis of platelet markers and inflammation markers in the diagnosis of acute appendicitis in adults
Publisher
[S. S. Dimić]
Format
[11], 173 lista
description
Biografija autora: list [174]
Bibliografija: listovi 139-173
description
Surgery
Abstract (en)
In order to reduce unnecessary laparotomies or overlooked cases of acute appendicitis (AA), a prospective clinical and biochemical study was conducted on 67 patients operated for suspected AA and the diagnostic accuracy and predictive value of platelet and inflammatory markers in the diagnosis of AA in adults and their correlation with Alvarado Scor(AS) and histopathology(HP)diagnosis were determined. After preoperative parameter determination, AS was calculated, surgery and HP appendix examination were performed and patients were divided into groups: catarrhal (CtAA), uncomplicated, phlegmonous(FAA,UCoAA), gangrenous and gangrenous perforated(CoAA). For statistical analysis, standard parametric and nonparametric tests were used. The most relevant measures in the final diagnosis of AA were the AS≥9 and the HP finding. By univariate regression, the probability ratio for AS≥9 and AS˂9 increases with a unit increase in CRP, neutrophil (Neu), neutrophil-lymphocyte ratio (NLR), total bilirubin (TBil)>21 μmol/l, procalcitonin (PCT)≥0.5ng/ml and HP finding CoAA. The probability ratio for HP finding of CoAA and UCoAA increases with a unit increase in CRP,Neu,NLR,AS,TBil>21μmol/l,PCT≥0.5ng/ml and AS≥9. Multifactor regression resulted in a model that explains 63.09% of the variability in the probability ratio of AS≥9 and AS˂9. In addition to the constant, this model consists of Neu, TBil>21μmol/l, HP finding CoAA and PCT≥0.5ng/ml. A model was also obtained that explains 54.19% of the variability in the probability ratios of the HP findings of CoAA and UCoAA. In addition to the constant, this model consists of the finding of AS≥9, the finding of PCT≥0.5ng/ml.
There are strong positive correlations of AS and Neu, AS and NLR,AS and IL-6,AS and PCT,NLR and IL-6,IL-6 and PCT,IL-6 and CRP in the whole sample of patients with AA. By selecting the appropriate preoperative parameters and including them in the mathematical formula of multifactor logistic regression, the need for an appropriate method of AA treatment can be reliably assessed.
Authors Key words
Markeri trombocita, markeri inflamacije, akutni apendicitis, odrasli
Authors Key words
Platelet markers, inflammatory markers, acute appendicitis, adults
Classification
616.346.2-002-07-053.8(043.3)
Subject
B 600
Type
Tekst
Abstract (en)
In order to reduce unnecessary laparotomies or overlooked cases of acute appendicitis (AA), a prospective clinical and biochemical study was conducted on 67 patients operated for suspected AA and the diagnostic accuracy and predictive value of platelet and inflammatory markers in the diagnosis of AA in adults and their correlation with Alvarado Scor(AS) and histopathology(HP)diagnosis were determined. After preoperative parameter determination, AS was calculated, surgery and HP appendix examination were performed and patients were divided into groups: catarrhal (CtAA), uncomplicated, phlegmonous(FAA,UCoAA), gangrenous and gangrenous perforated(CoAA). For statistical analysis, standard parametric and nonparametric tests were used. The most relevant measures in the final diagnosis of AA were the AS≥9 and the HP finding. By univariate regression, the probability ratio for AS≥9 and AS˂9 increases with a unit increase in CRP, neutrophil (Neu), neutrophil-lymphocyte ratio (NLR), total bilirubin (TBil)>21 μmol/l, procalcitonin (PCT)≥0.5ng/ml and HP finding CoAA. The probability ratio for HP finding of CoAA and UCoAA increases with a unit increase in CRP,Neu,NLR,AS,TBil>21μmol/l,PCT≥0.5ng/ml and AS≥9. Multifactor regression resulted in a model that explains 63.09% of the variability in the probability ratio of AS≥9 and AS˂9. In addition to the constant, this model consists of Neu, TBil>21μmol/l, HP finding CoAA and PCT≥0.5ng/ml. A model was also obtained that explains 54.19% of the variability in the probability ratios of the HP findings of CoAA and UCoAA. In addition to the constant, this model consists of the finding of AS≥9, the finding of PCT≥0.5ng/ml.
There are strong positive correlations of AS and Neu, AS and NLR,AS and IL-6,AS and PCT,NLR and IL-6,IL-6 and PCT,IL-6 and CRP in the whole sample of patients with AA. By selecting the appropriate preoperative parameters and including them in the mathematical formula of multifactor logistic regression, the need for an appropriate method of AA treatment can be reliably assessed.
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