Usefulness of serum sodium levels as a novel marker for predicting acute appendicitis severity: a retrospective cohort study

BMC Surgery

Research

Marcelo A. F. Ribeiro Junior¹  Jaques Waisberg²  Erica Mocchetti³  Tania Ichinose³  Isabella Cubas³  Bruno Messias⁴  Flavia Hashimoto⁵  Caio Oliveira⁵ 

[1] Critical Care and Acute Care Surgery, Sheikh Shakhbout Medical City- Mayo Clinic, P. O. Box 11001, Abu Dhabi, United Arab Emirates;Catholic University of São Paulo, 290, Joubert Wey Street, 18030-070, Sorocaba, SP, Brazil;Department of Surgery, ABC Medical School, Lauro Gomes Avenue, 2000, 09060-870, Santo André, SP, Brazil;Department of Surgery, General Hospital of Carapicuiba, 95, Pedreira street, 06321-665, Carapicuiba, SP, Brazil;Department of Surgery, General Hospital of Carapicuiba, 95, Pedreira street, 06321-665, Carapicuiba, SP, Brazil;Medical School, São Camilo University Center, Nazare Avenue, 1501, 04263- 200, São Paulo, SP, Brazil;Medical School, São Camilo University Center, Nazare Avenue, 1501, 04263- 200, São Paulo, SP, Brazil;

关键词: Acute appendicitis;    Hyponatremia;    Appendectomy;    Complicated appendicitis;   

DOI  :  10.1186/s12893-023-02224-y

 received in 2023-07-15, accepted in 2023-10-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundEarly and accurate preoperative diagnosis of complicated appendicitis mandates the identification of new markers. The aim of this study is to determine whether preoperative serum sodium levels are useful for predicting the severity of acute appendicitis.MethodsWe retrospectively analyzed 475 patients who underwent emergency appendectomies between January 2018 and February 2023 in a general hospital in Brazil. The patients were divided into 2 groups: complicated (n = 254) and uncomplicated (n = 221). Hyponatremia was defined as serum sodium levels < 136 mEq/L. The primary outcome was to evaluate if hyponatremia is associated with complicated appendicitis.ResultsThe patients had a median age of 22 years, and the median serum sodium level was 137 mEq/L in patients with complicated appendicitis and 139 mEq/L in uncomplicated appendicitis (P < 0.001). The analysis of the receiver operating characteristic curve used as the best cutoff value of serum sodium of 136 mEq/L with a sensitivity of 45.7%, specificity of 86.4%, positive predictive value of 79.5%, and negative predictive value of 58.1% for the diagnosis of complicated AA. Of the 254 patients with complicated appendicitis, 84 (33.1%) had serum sodium levels below 136 mEq/L, while only 12 (5.4%) patients with uncomplicated appendicitis had values ​​below this cutoff. Patients with hyponatremia were 5 times more likely to develop complicated appendicitis. (odds ratio: 5.35; 95% confidence interval: 3.39–8.45)ConclusionsPreoperative serum sodium levels are a useful tool for predicting the severity of acute appendicitis. Due to its low cost and wide availability, it has become an extremely relevant marker.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 3