Relationship of prognostic nutritional ındex, HALP score and ınflammatory markers with clinical outcomes in children with complicated appendicitis

One of the most frequent diagnoses in children presenting with acute abdominal pain is acute appendicitis. This study aims to analyze the effectiveness of the biomarkers such as the Prognostic Nutrition Index (PNI), hemoglobin-albumin-lymphocyte-platelet (HALP) score, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in predicting complicated appendicitis in children who undergo surgery for acute appendicitis. Material and Method: A total of 253 children who underwent surgery for acute appendicitis in our clinic between January 1, 2022, and October 1, 2024, and underwent surgery for acute appendicitis were included in our study. Results: Among the cases, 81% (n=205) were classified in the non-complicated, while 19% (n=48) were in the complicated group. In our analysis, we found that the PNI (p=0.027) and HALP score (p=0.007) were considerably lower in the complicated appendicitis group, whereas the neutrophil-to-lymphocyte ratio (NLR) (p=0.003) and platelet-to-lymphocyte ratio (PLR) (p=0.008) were significantly higher. Correlation analysis revealed a meaningful positive association between PNI and HALP score, a mild unfavorable association between PNI and both PLR and NLR, a strong positive correlation between HALP score and both PLR and NLR and a mild positive relationship between NLR and PLR. Conclusion: PNI, HALP score, NLR, and PLR values measured at the time of admission to the emergency services may serve as potential predictors in differentiating between complicated and non-complicated appendicitis.