The Role of Immature Granulocyte in Patients with Complex Appendicitis

Objective: The most frequent cause of emergency abdominal surgeries is acute appendicitis (AA). Biomarkers are utilized by Clinicians to aid in predicting acute or perforated appendicitis, which may influence treatment decisions. This study aims to examine the potential of immature granulocyte (IG), a robust marker of inflammatory response, in anticipating the occurrence of complications in patients with AA. Materials and Methods: This retrospective study covering 1 year was performed with patients who were operated on by general surgery with a preliminary diagnosis of AA. The study was conducted with a total of 470 patients, 303 of whom were uncomplicated and 167 were complicated, whose diagnosis was confirmed by Pathology reports and met the inclusion criteria. White blood cell (WBC), C-reactive protein, neutrophil, platelet, red cell distribution width, IG numbers, and percentages of the patients were recorded in the study form. Results: Arean under the curve values of WBC, neutrophil, and IG numbers were 0.590, 0.588, and 0.559, respectively, and we found that they were statistically significant. Each unit increase in the number of IG increases the probability of complication in appendicitis cases approximately 3333 times. Conclusion: In this study, we have demonstrated that the probability of having a complicated appendicitis (CA) is higher in AA patients with higher IG levels when distinguishing between complicated and in CA. Together with physical examination, imaging studies, and other laboratory tests, IG values can assist clinicians in identifying high-risk AA patients in the emergency department. Keywords: Acute abdomen diagnosis, appendicitis, complicated appendicitis, immature granulocytes