Diagnostic value of systemic immune inflammation index in acute appendicitis

SUMMARY OBJECTIVE: Clinical diagnosis of acute appendicitis is often difficult and involves a synthesis of clinical, laboratory, and radiological findings. The aim of this study was to investigate whether the systemic immune inflammation index can be used as an effective parameter in the diagnosis of acute appendicitis and its reliability in the differentiation of complicated vs. non-complicated appendicitis. METHODS: The study was conducted retrospectively with patients admitted to the emergency department with abdominal pain and diagnosed with acute appendicitis. In total, 150 patients and 150 control cases were included in the study. Demographic data, medical history, white blood cell count, platelet count, neutrophil count, systemic immune inflammation index values, Alvarado score, adult appendicitis score, and pathology result of appendectomy material were retrieved from the hospital automation system and recorded in the data form. RESULTS: Neutrophil-lymphocyte ratio and systemic immune inflammation index were significantly higher, and platelet-neutrophil ratio and lymphocyte-neutrophil ratio were significantly lower in the patient group compared to the control group (p<0.001). Receiver operating characteristic analysis revealed that the sensitivity and specificity of systemic immune inflammation index with a cutoff value of 840.13 was 82 and 66.7%, respectively, for the diagnosis of acute appendicitis. Correlation analysis revealed that systemic immune inflammation index, Alvarado score, and adult appendicitis score were positively correlated, and this correlation was statistically significant. CONCLUSION: Systemic immune inflammation index may be used to promote the diagnosis of acute appendicitis and may reduce the need for radiation exposure and diagnostic imaging tests such as contrast-enhanced abdominal computed tomography. It can also be used to differentiate between complicated and non-complicated acute appendicitis cases.

The new prognostic factor in pre-intubation follow-up of critically ill patients: integrated pulmonary index monitoring

SUMMARY OBJECTIVE: The objective of this study was to identify the integrated pulmonary index in the follow-up of non-intubated critically ill patients in the emergency department and its efficacy in deciding on advanced airway application in comparison with the Glasgow Coma Scale. METHODS: This is a prospective, single-center, methodological study. In our study, we recorded the demographic characteristics, Glasgow Coma Scale, and the integrated pulmonary index of 90 patients with respiratory failure who were followed up in the emergency department between June 1, 2019 and September 1, 2019, and we compared the results of Glasgow Coma Scale and integrated pulmonary index in making the endotracheal intubation decision. RESULTS: Endotracheal intubation was applied to 30% of the 90 patients included in the study. The area under the curve was calculated as 0.906 for integrated pulmonary index and 0.860 for Glasgow Coma Scale in predicting endotracheal intubation. There was no significant difference between the area under the curves of integrated pulmonary index and Glasgow Coma Scale. According to the best cutoff values determined in the estimation of endotracheal intubation, sensitivity was 74.07% and specificity was 95.24% for integrated pulmonary index, and sensitivity was 74.07% and specificity was 85.71% for Glasgow Coma Scale. CONCLUSION: The integrated pulmonary index monitoring provides an objective evaluation in the follow-up of critically ill patients with spontaneous breathing in the emergency department and is predictive in deciding on timely endotracheal intubation.

Humoral responses to the CoronoVac vaccine in healthcare workers

ABSTRACT Background: This study aimed to assess the immunoglobulin G (IgG) antibody response rate in emergency department (ED) healthcare workers (HCWs) and potential adverse effects after CoronaVac vaccination. Methods: All included HCWs were grouped based on the previous history of coronavirus disease 2019 (COVID-19) and the number of vaccinations. Furthermore, the IgG antibody response was evaluated based on the sex and smoking status of HCWs. Those with a cut-off index of ≥1.00 after vaccination with CoronaVac were considered to have had COVID-19 and had an adequate humoral response. Results: Among 224 ED HCWs, 18% experienced the adverse effects of CoronaVac vaccine, the most prevalent being pain in the injection site. The IgG antibody response rate was 20% after the first dose of vaccine, while the response rate increased to 90% after the second dose. Female HCWs had higher IgG response rates compared with male HCWs (53.8 [15.9-147.0] vs 31.2 [4.5-124.0]). Non-smokers had higher IgG response rate compared with smokers (49.0 [11.5-160.5] vs 23.1 [7.4-98.5]). Conclusion: A single dose of CoronaVac does not produce a sufficient antibody response; hence, two doses are recommended. Men have a lower IgG response compared with women. Smokers had a lower IgG response rate compared with non-smokers. Therefore, it may be necessary to carefully assess the humoral responses of men and smokers when implementing a community vaccination program.

Predictors of mortality in patients less than 50 years old with coronavirus disease 2019: a multicenter experience in Istanbul

SUMMARY OBJECTIVE: The objectives of this study were to identify predictors of mortality in young adult patients with coronavirus disease 2019 and to assess the link between blood type and mortality in those patients. METHODS: This multicenter retrospective study, which was conducted in seven training and research hospitals in Istanbul, involved young adults who aged ≥18 and <50 years and hospitalized with coronavirus disease 2019. RESULTS: Among 1,120 patients, confusion at admission (p<0.001) and oxygen saturation (p<0.001) were significantly predictive factors of mortality. Blood type O was significantly associated with mortality compared to those discharged from the hospital (p<0.001). Among co-morbidities, the most reliable predictive factors were cerebral vascular disease (p<0.001) and chronic renal failure (p=0.010). Among laboratory parameters, high C-reactive protein (p<0.001) and low albumin (p<0.001) levels were predictors of mortality in young adult patients with coronavirus disease 2019. CONCLUSIONS: SpO2 at admission was the best predictor of mortality in young adult patients with coronavirus disease 2019. The mortality rate was increased by cerebral vascular disease and chronic renal failure. Also, high C-reactive protein and low albumin levels were predictive factors of mortality. Moreover, blood type O was associated with a higher mortality rate than the other types.