Delta neutrophil index, CRP/albumin ratio, procalcitonin, immature granulocytes, and HALP score in acute appendicitis: Best performing biomarker?

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dc.contributor.authorCumaoglu, Mustafa Oguz
dc.contributor.authorAyan, Durmus
dc.contributor.authorVural, Abdussamed
dc.contributor.authorDolanbay, Turgut
dc.contributor.authorOzbey, Caner
dc.contributor.authorKulu, Abdul Ridvan
dc.date.accessioned2026-06-19T06:38:09Z
dc.date.available2026-06-19T06:38:09Z
dc.date.issued2025
dc.departmentMalatya Turgut Özal Üniversitesi
dc.description.abstractAim- This study investigates the diagnostic accuracy of five inflammatory biomarkers - delta neutrophil index (DNI); C-reactive protein/albumin ratio (CAR); procalcitonin (PCT); immature granulocytes count (IGc); and hemoglobin, albumin, lymphocyte, platelet score (HALPs) - in detecting acute appendicitis (AA) and identifying the most reliable marker for distinguishing complicated from non-complicated cases. Materials and methods- A prospective, cross-sectional study was conducted in a tertiary hospital emergency department, including 100 histopathologically confirmed AA patients and 100 healthy controls. Biomarker levels were analyzed using receiver operating characteristic curves. Sensitivity, specificity, and optimal cut-off values were determined via the Youden index, while logistic regression identified independent predictors of complicated appendicitis (CA). Results- DNI exhibited the highest diagnostic accuracy for AA (AUC: 0.87, 95% CI: 0.821-0.919, p < 0.001) with 92% specificity and 69% sensitivity at a cut-off of 71.88. CAR (AUC: 0.853) and PCT (AUC: 0.852) showed similar performance, whereas IGc (AUC: 0.695) and HALPs (AUC: 0.627) were less effective. DNI also outperformed the Alvarado score in predicting CA (AUC: 0.698 vs 0.626) and was an independent predictor (OR: 3.18, 95% CI: 1.40-7.24, p = 0.006). Conclusions- DNI demonstrated superior diagnostic performance for AA and was the most reliable marker for identifying CA. Its integration into clinical practice may enhance early diagnosis and reduce unnecessary surgeries, improving outcomes.
dc.identifier.doi10.1515/med-2025-1308
dc.identifier.issn2391-5463
dc.identifier.issue1
dc.identifier.orcid0000-0003-4245-1101
dc.identifier.orcid0000-0003-4506-916X
dc.identifier.pmid41141923
dc.identifier.scopus2-s2.0-105019351886
dc.identifier.scopusqualityN/A
dc.identifier.urihttps://doi.org/10.1515/med-2025-1308
dc.identifier.urihttps://hdl.handle.net/20.500.12899/5420
dc.identifier.volume20
dc.identifier.wosWOS:001596159400001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherDe Gruyter Poland Sp Z O O
dc.relation.ispartofOpen Medicine
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20260612
dc.subjectAcute Appendicitis
dc.subjectDelta Neutrophil Index
dc.subjectDiagnosis
dc.subjectEmergency Department
dc.subjectInflammatory Biomarker
dc.titleDelta neutrophil index, CRP/albumin ratio, procalcitonin, immature granulocytes, and HALP score in acute appendicitis: Best performing biomarker?
dc.typeArticle

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