o:1901
Komparativna analiza markera trombocita i markera inflamacije u dijagnostici akutnog apendicitisa kod odraslih
Comparative analysis of platelet markers and inflammation markers in the diagnosis of acute appendicitis in adults : doctoral dissertation
sr
In order to reduce unnecessary laparotomies or overlooked cases of acute appendicitis (AA), a prospective clinical and biochemical study was conducted on 67 patients operated for suspected AA and the diagnostic accuracy and predictive value of platelet and inflammatory markers in the diagnosis of AA in adults and their correlation with Alvarado Scor(AS) and histopathology(HP)diagnosis were determined. After preoperative parameter determination, AS was calculated, surgery and HP appendix examination were performed and patients were divided into groups: catarrhal (CtAA), uncomplicated, phlegmonous(FAA,UCoAA), gangrenous and gangrenous perforated(CoAA). For statistical analysis, standard parametric and nonparametric tests were used. The most relevant measures in the final diagnosis of AA were the AS≥9 and the HP finding. By univariate regression, the probability ratio for AS≥9 and AS˂9 increases with a unit increase in CRP, neutrophil (Neu), neutrophil-lymphocyte ratio (NLR), total bilirubin (TBil)>21 μmol/l, procalcitonin (PCT)≥0.5ng/ml and HP finding CoAA. The probability ratio for HP finding of CoAA and UCoAA increases with a unit increase in CRP,Neu,NLR,AS,TBil>21μmol/l,PCT≥0.5ng/ml and AS≥9. Multifactor regression resulted in a model that explains 63.09% of the variability in the probability ratio of AS≥9 and AS˂9. In addition to the constant, this model consists of Neu, TBil>21μmol/l, HP finding CoAA and PCT≥0.5ng/ml. A model was also obtained that explains 54.19% of the variability in the probability ratios of the HP findings of CoAA and UCoAA. In addition to the constant, this model consists of the finding of AS≥9, the finding of PCT≥0.5ng/ml.There are strong positive correlations of AS and Neu, AS and NLR,AS and IL-6,AS and PCT,NLR and IL-6,IL-6 and PCT,IL-6 and CRP in the whole sample of patients with AA. By selecting the appropriate preoperative parameters and including them in the mathematical formula of multifactor logistic regression, the need for an appropriate method of AA treatment can be reliably assessed.
Biografija autora: list [174]Bibliografija: listovi 139-173 Datum odbrane: 09.05.2023. Surgery
91552100
118981897
91552101
8611
2023-08-29T11:40:05.053Z
45
no
46
Saša, 1973-
Dimić
2157159
2023
63
mentor
Milan, 1971-
Radojković
8307559
2023
63
predsednik komisije
Nebojša
Đorđević
2023
63
član komisije
Miroslav
Stojanović
2023
63
član komisije
Goran
Stojanović
2023
63
član komisije
Dejan
Ivanov
2023
[11], 173 lista
4706261
http://phaidrani.ni.ac.rs/o:1901
no
yes
12
2023-08-29T11:40:05.320Z
70
Markeri trombocita, markeri inflamacije, akutni apendicitis, odrasli
Platelet markers, inflammatory markers, acute appendicitis, adults
616.346.2-002-07-053.8(043.3)
B 600
1738
18A05
18A0525
2023