• Saygın Altiner, Enes Cebeci, Bedri Burak Sucu, Mert Col, İlker Ermiş, Abdullah Senlikci, Yılmaz Ünal, and Mevlut Recep Pekcici.
• Ankara Training and Research Hospital, Department of General Surgery - Ankara, Turkey.
• Rev Assoc Med Bras (1992). 2022 Jan 1; 68 (12): 168116851681-1685.

ObjectiveThe aim of this study was to investigate the effectiveness of immature granulocyte count, immature granulocyte percentage, and total bilirubin value in predicting complicated and perforated appendicitis in patients aged 65 years and older with a diagnosis of appendicitis.MethodsIn this study, 84 patients, aged 65 years and older, who had appendectomy demographic information, preoperative white blood cell count, neutrophil/lymphocyte ratio, immature granulocyte count and immature granulocyte percentage, operation findings, and pathology results were collected retrospectively. They were grouped into 4 categories: complicated, non-complicated, perforated, and non-perforated, according to the data and surgical findings.ResultsTotal bilirubin and immature granulocyte count were found to be statistically significant in predicting complicated and perforated appendicitis in patients aged 65 years and older with a diagnosis of appendicitis. The total bilirubin was found to have the following values in differentiating complicated appendicitis: area under the curve=0.883, sensitivity=78.3%, and specificity=88.5%. Total bilirubin had the highest discrimination power with area under the curve=0.804 in differentiating perforation.ConclusionThe immature granulocyte percentage and total bilirubin count are the fast, inexpensive, and reliable parameters that can be used to predict complicated and perforated appendicitis in patients aged 65 years and older.

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