WOFAPS 2025 8th World Congress of Pediatric Surgery

Aim of the Study

The aim of this study is to compare the diagnostic value of the systemic immune/inflammation index(SII), which has recently been studied for its diagnostic utility in various inflammatory events, with the Alvarado score for the diagnosis of acute, perforated, and non-appendicitis cases.

Methods

The Alvarado scores, SII indices, and pathology results of 224 patients operated on with a preliminary diagnosis of appendicitis over a two-year period in our clinic were examined. Statistical analysis was performed using SPSS version22.0.

Main Results

Five patients were excluded from the study due to a diagnosis of parasitic infestation. Pathology reports showed that 58 patients had non-appendicitis, 144 had acute appendicitis, and 17 had perforated appendicitis.

The Alvarado score was statistically significant across all three groups. The SII index significantly distinguished non-appendicitis from both acute and perforated appendicitis. However, the Alvarado score demonstrated higher accuracy compared to the SII index in terms of both positive predictive value and negative predictive value.

Conclusions

The combined use of the Alvarado score and the SII index improves diagnostic accuracy for appendicitis, demonstrating a complementary effect between the two variables. While the Alvarado score alone provides high sensitivity, the SII index contributes additional diagnostic value by increasing specificity. In clinical practice, the combined evaluation of these two methods can lead to more accurate decision-making in diagnosing appendicitis. Particularly in ambiguous cases, using both the Alvarado score and the SII index together can help prevent unnecessary surgical interventions and guide appropriate follow-up decisions effectively.