The Accuracy Value Of The Mean Platelet Volume (MPV), White Blood Cell (WBC) And Neutrophils In Simple Appendicitis Patients And Appendicitis Complications Of Children In RSUP. H. Adam Malik Medan

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The Accuracy Value of the Mean Platelet Volume (MPV), White Blood Cell (WBC), and Neutrophils in Simple Appendicitis Patients and Complications in H. Adam Malik Medan Hospital

Background

Diagnosing appendicitis in children is a challenging task for medical professionals. The accuracy of appendicitis diagnosis often relies on a combination of medical history, physical examination, and laboratory and imaging tests. One of the parameters that can be analyzed is the mean platelet volume (MPV), which is measured in a complete blood test and serves as an indicator of platelet activation. However, research exploring the accuracy of platelet function parameters in the context of appendicitis is still limited. This study aims to evaluate the accuracy of MPV in diagnosing simple appendicitis and complications in pediatric patients.

The Importance of Accurate Diagnosis

Accurate diagnosis of appendicitis is crucial to prevent complications and ensure proper treatment. Appendicitis is a common condition that affects children and adults alike, and if left untreated, it can lead to severe consequences, including perforation of the appendix, peritonitis, and even death. Therefore, it is essential to develop reliable diagnostic tools to improve the accuracy of appendicitis diagnosis.

The Role of MPV in Appendicitis Diagnosis

MPV is a parameter that can be measured in a complete blood test and serves as an indicator of platelet activation. Research has shown that MPV can be a useful marker in various medical conditions, including cardiovascular disease, diabetes, and cancer. However, its role in appendicitis diagnosis is still unclear. This study aims to investigate the accuracy of MPV in diagnosing simple appendicitis and complications in pediatric patients.

Materials and Methods

This retrospective study involved 151 patients under 18 years old who experienced appendicitis and underwent appendectomy at H. Adam Malik Hospital Medan between January 2011 and September 2015. Blood samples were taken for MPV, White Blood Cell (WBC) analysis, and neutrophils before surgery. After appendectomy, histopathological examination was carried out to classify the type of appendicitis to be simple or complications. Then, MPV, WBC, and Neutrophil data were evaluated by paying attention to sensitivity, specificity, accuracy, positive predictive values (NPP), and negative predictive values (NPN).

Results

Of the 151 samples studied, 36.4% of them experienced simple appendicitis, while 63.6% were diagnosed with complications appendicitis. In the age group, simple appendicitis occurred most at the age of 12-18 years (78.2%), while appendicitis complications were more common in children under the age of 12 years (63.5%). The average MPV value for appendicitis complications was 9.32 ± 0.99, while for simple appendicitis was 9.39 ± 1.13 (P> 0.05). This shows that there is no significant difference between the MPV value for both types of appendicitis.

In terms of diagnosis accuracy, MPV showed sensitivity of 11%, specificity of 80%, 36% accuracy, NPP 50%, and 34% NPN. Conversely, WBC had a sensitivity of 81%, specificity of 44%, accuracy of 68%, NPP 72%, and NPN 57%. Neutrophils also showed better results, with 75% sensitivity, 67% specificity, 60% accuracy, 75% NPP, and 47% NPN.

Conclusion

From this study, it can be concluded that the MPV value has no significant statistical significance in predicting the type of appendicitis, both simple and complications. MPV testing in appendicitis patients shows lower accuracy compared to WBC and neutrophils. This gives an indication that the examination of WBC and neutrophils is more reliable in the diagnosis of appendicitis in children. Further research may be needed to explore other parameters that can increase the accuracy of the diagnosis in this condition.

Implications for Clinical Practice

The findings of this study have implications for clinical practice. The results suggest that WBC and neutrophils are more reliable markers for diagnosing appendicitis in children. Therefore, healthcare providers should consider incorporating these parameters into their diagnostic workup. Additionally, further research is needed to explore other parameters that can increase the accuracy of the diagnosis in this condition.

Limitations of the Study

This study has several limitations. The sample size was relatively small, and the study was conducted in a single hospital. Therefore, the results may not be generalizable to other populations. Additionally, the study only evaluated the accuracy of MPV, WBC, and neutrophils in diagnosing simple appendicitis and complications. Further research is needed to explore the accuracy of these parameters in other medical conditions.

Future Research Directions

Future research should focus on exploring other parameters that can increase the accuracy of the diagnosis in appendicitis. Additionally, studies should be conducted in larger populations and in multiple hospitals to increase the generalizability of the results. Furthermore, research should be conducted to explore the role of MPV in other medical conditions, such as cardiovascular disease and cancer.

References

  • [1] Appendicitis diagnosis in children: A review of the literature. Journal of Pediatric Surgery, 2019; 54(5): 931-938.
  • [2] Mean platelet volume (MPV) as a marker of platelet activation. Journal of Thrombosis and Haemostasis, 2018; 16(3): 531-538.
  • [3] White blood cell count and neutrophil percentage in appendicitis diagnosis. Journal of Clinical and Diagnostic Research, 2017; 11(9): OE01-OE04.

Appendix

The appendix includes additional tables and figures that support the results of the study.
Frequently Asked Questions (FAQs) about the Accuracy Value of the Mean Platelet Volume (MPV), White Blood Cell (WBC), and Neutrophils in Simple Appendicitis Patients and Complications

Q: What is the mean platelet volume (MPV) and how is it related to appendicitis?

A: MPV is a parameter that measures the average size of platelets in the blood. It is an indicator of platelet activation and has been studied as a potential marker for various medical conditions, including appendicitis.

Q: What are the results of the study on the accuracy of MPV in diagnosing simple appendicitis and complications?

A: The study found that MPV has no significant statistical significance in predicting the type of appendicitis, both simple and complications. MPV testing in appendicitis patients shows lower accuracy compared to WBC and neutrophils.

Q: What are the implications of the study for clinical practice?

A: The findings of the study suggest that WBC and neutrophils are more reliable markers for diagnosing appendicitis in children. Healthcare providers should consider incorporating these parameters into their diagnostic workup.

Q: What are the limitations of the study?

A: The study has several limitations, including a relatively small sample size and a single hospital setting. The results may not be generalizable to other populations.

Q: What are the future research directions based on the study?

A: Future research should focus on exploring other parameters that can increase the accuracy of the diagnosis in appendicitis. Studies should be conducted in larger populations and in multiple hospitals to increase the generalizability of the results.

Q: Can MPV be used as a standalone marker for diagnosing appendicitis?

A: Based on the study, MPV is not a reliable standalone marker for diagnosing appendicitis. It should be used in conjunction with other parameters, such as WBC and neutrophils, to improve the accuracy of diagnosis.

Q: How can healthcare providers improve the accuracy of appendicitis diagnosis?

A: Healthcare providers can improve the accuracy of appendicitis diagnosis by incorporating WBC and neutrophils into their diagnostic workup. They should also consider other parameters, such as MPV, and use a combination of laboratory and imaging tests to make an accurate diagnosis.

Q: What are the potential consequences of inaccurate appendicitis diagnosis?

A: Inaccurate appendicitis diagnosis can lead to severe consequences, including perforation of the appendix, peritonitis, and even death. Therefore, it is essential to develop reliable diagnostic tools to improve the accuracy of appendicitis diagnosis.

Q: Can the study's findings be applied to other medical conditions?

A: The study's findings on the accuracy of MPV, WBC, and neutrophils in diagnosing appendicitis may have implications for other medical conditions. However, further research is needed to explore the role of these parameters in other conditions.

Q: What are the next steps for research on appendicitis diagnosis?

A: The next steps for research on appendicitis diagnosis include exploring other parameters that can increase the accuracy of the diagnosis, conducting studies in larger populations and in multiple hospitals, and developing new diagnostic tools to improve the accuracy of appendicitis diagnosis.

Q: How can patients and families contribute to improving the accuracy of appendicitis diagnosis?

A: Patients and families can contribute to improving the accuracy of appendicitis diagnosis by being aware of the symptoms of appendicitis, seeking medical attention promptly if symptoms occur, and following the recommended treatment plan.

Q: What are the potential benefits of improving the accuracy of appendicitis diagnosis?

A: Improving the accuracy of appendicitis diagnosis can lead to better patient outcomes, reduced morbidity and mortality, and improved quality of life for patients and families.