Is Hyponatremia a Predictor for Perforated Appendicitis in Children?

Introduction: Acute appendicitis (AA) is a leading cause morbidity and mortality in childhood. Unfortunately AA can be difficult to distinguish from other clinical conditions during the early course of the disease. Biomarkers are molecular indicators of a disease process, diagnosis, prognosis and can be used to monitor the effects of disease management. We aimed to determine which of the demographic, clinical or laboratory data is more predictive for complicated AA. Materials and Methods: A hundred fourty five consecutive patients aged 1 month to 18 years diagnosed with AA were retrospectively analyzed. Age, gender, body temperature (degrees C), laboratory data and symptom duration (days) of the patients were recorded. Results: A total of 145 children with AA, 38 in group 1 and 107 in group 2, were included in the study. Group 1 was perforated appendicitis and group 2 was nonperforated appendicitis. Plasma sodium value was lower in group 1 than group 2, and C-reactive protein (CRP) values were significantly lower in group 2 compared to group 1. Conclusion: Laboratory values can guess complicated appendicitis in children with appendicitis. CRP level and presence of hyponatremia may be more predictive than white blood cell count for the the diagnosis of perforated appendicitis.