The ability of the Immune Systemic Inflammation Index (ISII) to diagnose complicated acute appendicitis in a referral hospital in Peru

Virú-Flores H.M.; Roque-Quezada J.C.; Medina-Jimenez A.N.; Román-Yrigoín M.J.; Barturen-Julca V.A.; Vega-Vega R.R. · Revista Colombiana de Cirugia (2025) · DOI: 10.30944/20117582.2847

Resumen

Introduction. Acute appendicitis is the most common cause of surgical acute abdomen in emergency departments. In recent years, hematologic biomarkers, such as the Immune Systemic Inflammation Index (ISII), have been investigated to predict disease severity and specifically differentiate between complicated and uncomplicated acute appendicitis. However, their implementation in clinical practice is not yet established. Methods. A retrospective analytical study was conducted to evaluate a diagnostic test. The IISI, neutrophillymphocyte ratio, red blood cell distribution width, and Alvarado score were calculated to assess their operating characteristics as predictors of complicated acute appendicitis. Results. A sample of 482 patients diagnosed with acute appendicitis was selected: 152 with complicated acute appendicitis and 330 with uncomplicated acute appendicitis. The IISI showed an area under the curve (AUC) of 0.832 (p=0.001), with a cutoff value ≥1987, achieving a sensitivity of 77.6% and a specificity of 71.8%. The IISI showed the highest diagnostic yield compared with the other biomarkers evaluated. Conclusions. In this study, the immune systemic inflammation index showed operating characteristics consistent with adequate prediction of complicated acute appendicitis.

Instituciones: Universidad Científica del Sur; Universidad Privada San Juan Bautista; Universidad César Vallejo