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

Abstract

Background: Acute appendicitis is a common surgical
problem that is associated with an acute-phase reaction.
Previous studies have shown that cytokines and acutephase 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