The role of red cell distribution width in the diagnosis of acute appendicitis: a retrospective case-controlled study

World Journal of Emergency Surgery

Keziban Karabulut³  Turhan Togan²  Erdal Karagulle¹  Emin Turk¹  Huseyin Narci³ 

[1] Department of General Surgery, Baskent University Faculty of Medicine, Ankara, Turkey;Department of Infectious Diseases and Clinical Microbiology, Baskent University Faculty of Medicine, Ankara, Turkey;Department of Emergency Medicine, Baskent Universitesi Konya Hastanesi Hocacihan mah, Saray caddesi No: 1, Selcuklu, Konya 42080, Turkey

关键词: Red cell distribution width;    Leukocyte;    C-reactive protein;    Acute appendicitis;   

Others  :  791601
DOI  :  10.1186/1749-7922-8-46

 received in 2013-09-18, accepted in 2013-10-31,  发布年份 2013

【 摘 要 】

Purpose

The aim of this study was to seek whether red cell distribution width (RDW) has a role in the diagnosis of acute appendicitis. It was also aimed to show the relationship of RDW with leukocyte count and C-reactive protein (CRP) level.

Methods

This study was conducted via retrospective assessment of the hospital records of the adult patients who were operated for acute appendicitis between January 2010 and February 2013 and had a pathology report that confirmed the diagnosis of acute appendicitis. The patients in the control group were selected from healthy adults of similar age who applied to check-up clinic. Age, gender, leukocyte count, CRP, and RDW values were recorded. This study is a case controlled retrospective clinical study.

Results

A total of 590 patients in the acute appendicitis group and 121 patients in the control group were included, making up a total of 711 subjects. The mean RDW levels were 15.4 ± 1.5% in the acute appendicitis group, while 15.9 ± 1.4% in the control group. CRP, leukocyte count were significantly higher in the acute appendicitis group, and RDW level were significantly lower in the acute appendicitis group (p < 0.001, p < 0.001, p = 0.001, respectively). RDW, leukocyte count, and CRP had a sensitivity and specificity of 47% and 67%; 91% and 74%; and 97% and 41%, respectively in acute appendicitis. RDW was not correlated with CRP and leukocyte levels. However, we found a correlation between CRP and leukocyte levels.

Conclusion

RDW level was lower in patients with acute appendicitis. The magnitude of difference in RDW seen between acute appendicitis and controls was so slight as to be of no utility in diagnostic testing.

【 授权许可】

   
2013 Narci et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Humes DJ, Simpson J: Acute appendicitis. BMJ 2006, 333:530-534.
• [2]Bickell NA, Aufses AH Jr, Rojas M, Bodian C: How time affects the risk of rupture in appendicitis. J Am Coll Surg 2006, 202:401-406.
• [3]Shefki X, Lumturije GL, Kumrije X, Fahredin V, Besnik B, Fatos S, Avdyl K: Correlation of serum C-reactive protein, white blood count and neutrophil percentage with histopathology findings in acute appendicitis. World J Emerg Surg 2012, 7:27. BioMed Central Full Text
• [4]Ashdown HF, D'Souza N, Karim D, Stevens RJ, Huang A, Harnden A: Pain over speed bumps in diagnosis of acute appendicitis: diagnostic accuracy study. BMJ 2012, 345:e8012.
• [5]Karagulle E, Turk E, Ezer A, Nursal TZ, Kulaksızoglu S, Moray G: Value of plasma viscosity in acute appendicitis: a preliminary. J Med Med Sci 2010, 1:423-425.
• [6]Harmanci O, Kav T, Sivri B: Red cell distribution width can predict intestinal atrophy in selected patients with celiac disease. J Clin Lab Anal 2012, 26:497-502.
• [7]Öztürk ZA, Ünal A, Yiğiter R, Yesil Y, Kuyumcu ME, Neyal M, Kepekçi Y: Is increased red cell distribution width (RDW) indicating the inflammation in Alzheimer's disease (AD)? Arch Gerontol Geriatr 2013, 56:50-54.
• [8]Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJ, Pfeffer MA, Swedberg K, Wang D, Yusuf S, Michelson EL, Granger CB, CHARM Investigators: Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol 2007, 50:40-47.
• [9]Hampole CV, Mehrotra AK, Thenappan T, Gomberg-Maitland M, Shah SJ: Usefulness of red cell distribution width as a prognostic marker in pulmonary hypertension. Am J Cardiol 2009, 104:868-872.
• [10]Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M, for the Cholesterol and Recurrent Events (CARE) Trial Investigators: Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation 2008, 117:163-168.
• [11]Ku NS, Kim HW, Oh HJ, Kim YC, Kim MH, Song JE, Oh DH, Ahn JY, Kim SB, Jeong SJ, Han SH, Kim CO, Song YG, Kim JM, Choi JY: Red blood cell distribution width is an independent predictor of mortality in patients with gram-negative bacteremia. Shock 2012, 38:123-127.
• [12]Senol K, Saylam B, Kocaay F, Tez M: Red cell distribution width as a predictor of mortality in acute pancreatitis. Am J Emerg Med 2013. doi: 10.1016/j.ajem.2012.12.015. [Epub ahead of print]
• [13]Sadaka F, O'Brien J, Prakash S: Red cell distribution width and outcome in patients with septic shock. J Intensive Care Med 2012. [Epub ahead of print]
• [14]Andersson REB: Meta-analysis of the clinical and laboratory diagnosis of appendicitis. Br J Surg 2004, 91:28-37.
• [15]Birchley D: Patients with clinical acute appendicitis should have pre-operative full blood count and C-reactiveprotein assays. Ann R Coll Surg Engl 2006, 88:27-32.
• [16]Albayrak Y, Albayrak A, Albayrak F, Yildirim R, Aylu B, Uyanik A, Kabalar E, Güzel IC: Mean platelet volume: a new predictor in confirming acute appendicitis diagnosis. Clin Appl Thromb Hemost 2011, 17:362-366.
• [17]Hallan S, Asberg A, Edna TH: Additional value of biochemical tests in suspected acute appendicitis. Eur J Surg 1997, 163:5333-5338.
• [18]Ani C, Ovbiagele B: Elevated red blood cell distribution width predicts mortality in persons with known stroke. J Neurol Sci 2009, 277:103-108.
• [19]Malandrino N, Wu WC, Taveira TH, Whitlatch HB, Smith RJ: Association between red blood cell distribution width and macrovascular and microvascular complications in diabetes. Diabetologia 2012, 55:226-235.
• [20]Kim J, Kim K, Lee JH, Jo YH, Rhee JE, Kim TY, Kang KW, Kim YJ, Hwang SS, Jang HY: Red blood cell distribution width as an independent predictor of all-cause mortality in out of hospital cardiac arrest. Resuscitation 2012, 83:1248-1252.
• [21]Spell DW, Jones DV Jr, Harper WF, David BJ: The value of a complete blood count in predicting cancer of the colon. Cancer Detect Prev 2004, 28:37-42.
• [22]Patel KV, Ferrucci L, Ershler WB, Longo DL, Guralnik JM: Red blood cell distribution width and the risk of death in middle-aged and older adults. Arch Intern Med 2009, 169:515-523.
• [23]Perlstein TS, Weuve J, Pfeffer MA, Beckman JA: Red blood cell distribution width and mortality risk in a community-based prospective cohort. Arch Intern Med 2009, 169:588-594.
• [24]Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC: Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med 2009, 133:628-632.