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Apendicitis aguda guiada por biomarcadores plasmáticos y de orina. Estudio de casos y controles.

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Title: Apendicitis aguda guiada por biomarcadores plasmáticos y de orina. Estudio de casos y controles.
Alternate Title: Acute appendicitis guided by plasma and urine biomarkers. Case-control study.
Authors: Martínez-Sebastián, Alicia1 aliciamarsebastian@gmail.com, Rodríguez-Varela, Ana1,2, Colomer-Revuelta, Julia2,3, Carrasco-Luna, Joaquín2,4, Carrasco-García, Álvaro2, García-Valdelvira, María5, Codoñer-Franch, Pilar1,2
Source: Andes Pediatrica. Jun2025, Vol. 96 Issue 3, p377-385. 9p.
Subjects: APPENDICITIS, BIOMARKERS, CASE-control method, PEDIATRICS, SURGICAL emergencies, URINALYSIS, DIAGNOSIS
Abstract (English): Acute appendicitis is a surgical emergency in pediatrics. An accurate diagnosis, based on new biomarkers, could reduce associated complications. Objective: to assess the usefulness of blood and urine biomarkers in the diagnosis of acute appendicitis in pediatrics. Patients and Method: Prospective, analytical, observational case-control study, conducted in a single center between 2019-2022. The study population consisted of 160 children aged between 0 and 15 years, divided into two groups (80 children with acute appendicitis and 80 without it), who consulted due to abdominal pain suggestive of acute abdomen, evaluated with biochemical markers and ultrasound for diagnosis. For evaluation, blood markers included C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), proadrenomedullin (proADM), pentraxin 3 (PTX3), tumor necrosis factor alpha (TNF-alpha), and interleukin 6 (IL6) and the urine marker leucine-rich alpha-2-glycoprotein (LRG). Simple binary logistic regression models were estimated to study their association with the variables analyzed, estimation of a multiple model with a stepwise entry method, and subsequent obtaining of adjusted ORs and construction of ROC curves. We considered a p < 0.05 as significant. Results: Compared with controls, leukocyte count (AUC 0.829), neutrophils (AUC 0.836), and NLR (AUC 0.797) were significantly higher in the appendicitis group (p < 0.001), while the TNF-alpha elevation (AUC 0.959) reduced the prediction of appendicitis, without differences in the other biomarkers analyzed. Conclusions: The values of leukocytes, neutrophils, NLR, and TNF-alpha are those that best discriminate acute appendicitis from other etiologies of abdominal pain. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): La apendicitis aguda, es una emergencia quirúrgica en pediatría. Un diagnóstico preciso, apoyado en nuevos biomarcadores podría disminuir las complicaciones asociadas. Objetivo: valorar la utilidad de biomarcadores en sangre y orina en el diagnóstico de apendicitis aguda en pediatría. Pacientes y Método: Estudio observacional analítico prospectivo de casos y controles, realizado en un centro entre 2019-2022. La población estudiada estuvo compuesta por 160 niños de entre 0 y 15 años, divididos en dos grupos (80 niños con apendicitis aguda y 80 sin apendicitis aguda), que consultaron por dolor abdominal sugestivo de abdomen agudo, evaluados con analítica y ecografía para su diagnóstico. Se evaluaron marcadores en sangre (proteína C reactiva (PCR), índice neutrófilo linfocito (INL), proadrenomedulina (PADM), pentraxina 3 (PTX3), factor de necrosis tumoral alfa (TNF-alfa), interleucina 6 (IL6) y orina (alfa-2-glicoproteina rica en leucina (A2GRL). Se estimaron modelos de regresión logística binaria simple para estudiar su asociación con variables analizadas, estimación de un modelo múltiple con método de entrada paso a paso y consiguiente obtención de OR ajustados y construcción de curvas ROC. Consideramos como significativo un p < 0,05. Resultados: Comparado con controles, el recuento de leucocitos (AUC 0.829), neutrófilos (AUC 0.836) e INL (AUC 0,797) fueron significativamente superiores en el grupo apendicitis (p < 0,001), mientras que la elevación TNF-alfa (AUC 0,959) redujo la predicción de apendicitis, sin diferencias en los otros biomarcadores analizados. Conclusiones: Los valores de leucocitos, neutrófilos, INL y TNF-alfa son los que mejor discriminan apendicitis aguda de otras causas de dolor abdominal. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
Description
Abstract:Acute appendicitis is a surgical emergency in pediatrics. An accurate diagnosis, based on new biomarkers, could reduce associated complications. Objective: to assess the usefulness of blood and urine biomarkers in the diagnosis of acute appendicitis in pediatrics. Patients and Method: Prospective, analytical, observational case-control study, conducted in a single center between 2019-2022. The study population consisted of 160 children aged between 0 and 15 years, divided into two groups (80 children with acute appendicitis and 80 without it), who consulted due to abdominal pain suggestive of acute abdomen, evaluated with biochemical markers and ultrasound for diagnosis. For evaluation, blood markers included C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), proadrenomedullin (proADM), pentraxin 3 (PTX3), tumor necrosis factor alpha (TNF-alpha), and interleukin 6 (IL6) and the urine marker leucine-rich alpha-2-glycoprotein (LRG). Simple binary logistic regression models were estimated to study their association with the variables analyzed, estimation of a multiple model with a stepwise entry method, and subsequent obtaining of adjusted ORs and construction of ROC curves. We considered a p < 0.05 as significant. Results: Compared with controls, leukocyte count (AUC 0.829), neutrophils (AUC 0.836), and NLR (AUC 0.797) were significantly higher in the appendicitis group (p < 0.001), while the TNF-alpha elevation (AUC 0.959) reduced the prediction of appendicitis, without differences in the other biomarkers analyzed. Conclusions: The values of leukocytes, neutrophils, NLR, and TNF-alpha are those that best discriminate acute appendicitis from other etiologies of abdominal pain. [ABSTRACT FROM AUTHOR]
ISSN:24526045
DOI:10.32641/andespediatr.v96i3.5468