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Evaluation of Serum Interleukin-6 Levels inCorrelation to the Severity of Acute Appendicitis

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Abstract

Background: Acute appendicitis is a common surgical problem that is associated with an acute-phase reaction. Previous studies have shown that cytokines and acute-phase proteins are activated and may serve as indicators for appendicitis.Objective: The aim of this study was to evaluate of serum levels of interleukin-6 (IL-6) in correlation to the severity to acute appendicitis.Methods: This is a prospective study from December 2008 to March 2009 of patients who had appendectomy in Department of Surgery, Al-Kindy Teaching Hospital - Baghdad/Iraq. Serum for estimating levels of interleukin-6 (IL-6) was taken pre-operatively. Depending on the macroscopic evidence during the operation and the histopathological examination of the specimens, the patients were separated into 3 groups, group one with negative appendectomy (normal appendix), group two with non-complicated acute appendicitis (catarrhal, suppurative), and group three with complicated acute appendicitis (perforated, gangrenous). The histopathological results were correlated with IL-6 values statistically.Results: A total number of 50 patients were included in this study, 28 male (56%) and 22 female (44%). The mean age was 23 year (ranged from 7 to 50). On histological examination, there were 7 patients (14%) in group one, 29 patients (58%) in group two, and 14 patients (28%) in group three. Serum IL-6 values gave true negative results in 6%, true positive results in 82%, false negative results in 4%, and false positive results in 8%. We determined, therefore, in the present study the sensitivity, specificity, and accuracy of serum IL-6 were calculated as 95.34%, 42.85%, and 88% respectively.Conclusion: Laboratory results should be considered to be integrated within the clinical assessment. If used critically, IL-6 can provide surgeons with complementary information in discerning the necessity for urgent operation.

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