Predictive Factors for Acute and Complicated Appendicitis in Children: A Prospective Study

Introduction: Acute appendicitis is one of the most common surgical emergencies in children, where early diagnosis is crucial to reducing morbidity and mortality.This study aimed to identify predictive factors for appendicitis and evaluate the diagnostic value of serum sodium and blood and urine ketone levels.Methods: This prospective study included patients under 18 years of age who presented with acute abdominal pain and were clinically suspected of having appendicitis.Patients were divided into two groups: appendicitis and non-appendicitis.The appendicitis group was further categorized into acute and complicated cases.Demographic data, clinical symptoms, physical examination findings, symptom duration, preoperative laboratory values, blood and urine ketone levels, and pathology results were recorded.Results: A total of 153 patients were included [100 with appendicitis (51 complicated) and 53 non-appendicitis].In the appendicitis group, leukocyte count, neutrophil count, C-reactive protein (CRP), blood ketones [area under the curve (AUC)=0.618],and urine ketones (AUC=0.627)were significantly higher (p<0.001,p<0.001, p=0.001, p=0.03, and p=0.04, respectively).Among patients presenting within 24 hours of symptom onset, leukocyte count (p=0.013),neutrophil count (p=0.014), and blood ketones (p=0.035) were significantly higher in the appendicitis group.For patients with symptom duration longer than 24 hours, leukocyte count (p=0.005),neutrophil count (p=0.001), and CRP levels (p=0.001) were significantly elevated, while serum sodium levels were significantly lower (p=0.046) in appendicitis cases. zGiri: Akut apandisit, ocuklarda en sk grlen cerrahi acil durumlardan biridir.Morbidite ve mortaliteyi azaltmak iin erken tan kritik neme sahiptir.Bu almann amac, apandisit iin ngrc faktrleri belirlemek ve serum sodyum ile kan ve idrar keton dzeylerinin tan deerini deerlendirmektir