Arif İsmet ÇATAK, Sabri CANSARAN
Türkiye Çocuk Hastalıkları Dergisi - 2026;20(2):79-83
Objective: Acute appendicitis (AA) is a leading cause of pediatric abdominal pain requiring surgical intervention. Differentiating simple appendicitis (SA) from complicated appendicitis (CA) preoperatively remains a clinical challenge. This study aimed to evaluate the diagnostic and prognostic utility of routinely available inflammatory markers-including C-reactive protein (CRP), fibrinogen, immature granulocyte (IG) count and percentage, neutrophil-to-lymphocyte ratio (NLR), and mean platelet volume (MPV)-in children with AA. Material and Methods: This retrospective study included pediatric patients (<18 years) who underwent appendectomy for AA between January 2020 and December 2022. Patients were categorized as having SA or CA based on intraoperative and histopathological findings. Preoperative laboratory parameters were compared between groups. Spearman correlation and regression analyses were performed to assess associations with complication status and hospitalization duration. Results: A total of 94 patients were included (mean age: 12.1+/-3.6 years; 63.8% male). CA was identified in 9 patients (9.6%). CRP levels were significantly higher in the CA group (p = 0.043) and independently predicted complications (OR: 1.018, 95% CI: 1.005-1.032, p =0.009). CRP was moderately correlated with both hospital stay (r =0.369, p <0.001) and fibrinogen levels (r =0.525, p <0.001). In multivariate linear regression, CRP remained a significant predictor of prolonged hospitalization (beta =0.365, p =0.002), while fibrinogen did not. IG count, IG percentage, NLR, and MPV were not significantly associated with complication status or hospital stay. Conclusion: CRP is a practical and reliable marker for predicting both complicated appendicitis and prolonged hospitalization in children. Fibrinogen is associated with disease burden but lacks independent predictive value. IG%, NLR, and MPV did not demonstrate clinical utility in this cohort. CRP may aid in preoperative risk stratification and postoperative care planning in pediatric AA.
