Comment to: “Inflammatory parameters as predictive factors for complicated appendicitis: A retrospective cohort study’’


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Peksöz R., Albayrak Y., Atamanalp S. S.

Annals of Medicine and Surgery, cilt.75, sa.3, ss.103391, 2022 (ESCI)

  • Yayın Türü: Makale / Editöre Mektup
  • Cilt numarası: 75 Sayı: 3
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1016/j.amsu.2022.103391
  • Dergi Adı: Annals of Medicine and Surgery
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus
  • Sayfa Sayıları: ss.103391
  • Atatürk Üniversitesi Adresli: Evet

Özet

Comment to: “Inflammatory parameters as predictive factors for complicated appendicitis: A retrospective cohort study’’

Dear Editor,

We have read the valuable article titled “Inflammatory parameters as predictive factors for

complicated appendicitis: A retrospective cohort study’’ by Ribeiro et al. [1] with a great

interest. In this article, the authors explained the situation of predicting the complexity of the

appendix by looking at analytical predictive factors. These easily accessible basic parameters

are very important, especially for physicians in rural areas or those who have difficulty in

accessing advanced imaging methods. In this regard, this study will make a significant

contribution to the literature. Howewer, some issues should be raised our point of view.

Firstly, Ribeiro et al. [1] emphasized the importance of basic laboratory parameters such as

complete blood count parameters (CBC) parameters and C-reactive protein (CRP). This basic

labaratory parameters are affected by various factors, like chronic diseases, haematological

diseases, allergic diseases, various drugs, malignant or inflammatory diseases [2,3].

Therefore, patients with diseases that may affect basic labaratory parameters should be

excluded from this study. Failure to exclude these patients from the study will lead to

misleading assessments.

Secondly, the patients were divided into two groups, but the negative appendectomy group

was not mentioned. Especially in pregnant patients, this rate (17.27-36%) may be higher and

this is a serious rate [4,5]. In this regard, negative appendectomy rate should be given in this

study, and the diagnostic value of analytical predictive factors should be used to determine the

negative appendectomy group. Again, as far as we understand, gangrenous appendicitis was

evaluated in the uncomplicated patient group. However, this patient group was evaluated in

the complicated appendicitis group in other studies [3,6]. This situation should be re-

evaluated.

Thirdly, to better understand the clinical characteristics of the patient groups, table 2 should

include important parameters such as co-morbid diseases, postoperative complications

according to the Clavien-Dindo classification [7], and cutt-off values of labaratory

parameters.

Finally, basic biochemical laboratory parameters, like CBC parameters, have high diagnostic

value in determining complicated or uncomplicated apendicitis. We found that white blood

cell, neutrophil, neutrophil to lymphocyte ratio, platelet, platelet to lymphocyte ratio, lactate

dehydrogenase, indirect, direct and total bilirubin can be utilized to diagnose complicated

appendicitis [5]. Therefore, using the basic biochemical parameters as well as CBC and CRP will make the study more valuable.

Provenance and peer review

Not commissioned, externally peer reviewed.Journal Pre-proof