Diagnostic value of hematological parameters in the early diagnosis of acute cholecystitis

Abstract

Objectives Accurate diagnosis of acute cholecystitis (AC) is critical because early laparoscopic cholecystectomy significantly reduces complications and mortality. This study evaluates the predictive value of inflammatory indices and hematological markers in diagnosing AC. Methods A retrospective review was performed on early laparoscopic cholecystectomy cases at the Gaziosmanpa & scedil;a Training and Research Hospital in Istanbul between August 2013 and August 2023. Patient demographics, preoperative laboratory values, inflammatory indices - including neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) - were evaluated, along with hospital length of stay and histopathological outcomes. Results Among 249 patients, 34 (13.6%) were diagnosed with AC, comprising 76 males (30.5%) and 173 females (69.5%), with a mean age of 48.9 +/- 14.6 years. The median hospital length of stay was 3 days (range: 1-21). Significant elevations in both the SIRI and neutrophil count were observed in AC cases compared to controls (P < 0.001). ROC (receiver operating characteristic) curve analysis demonstrated comparable diagnostic performance for the SIRI (AUC = 0.746; 95% CI: 0.658-0.835; optimal cutoff: 1.98) and neutrophil count (AUC = 0.746; 95% CI: 0.658-0.835; optimal cutoff: 7.1 x 103/mu L) in predicting AC. Conclusions The SIRI and neutrophil count are reliable markers that can improve the diagnostic accuracy and guide early management of AC.