HYPONATREMIA AS A PREDICTOR OF PERFORATED ACUTE APPENDICITIS IN PEDIATRIC POPULATION: A PROSPECTIVE STUDY

Abstract Background The aim of this study was to investigate hyponatremia as a new biochemical marker associated with complicated appendicitis in the pediatric population. Methods Pediatric patients (n = 184) with acute appendicitis confirmed by histopathology were enrolled in a prospective cohort study from January 2019 to May 2020. Medical history, demographic and clinical data were recorded in the study protocol. Blood samples for biochemical analysis, electrolytes and acute inflammatory markers were taken before surgery. Patients were further divided in two groups, those with non-perforated (n = 148; 79%) and perforated appendicitis (n = 38; 21%). Results The mean serum sodium level in patients with complicated appendicitis was significantly lower compared to patients with non-complicated appendicitis (132.2 mmol/L vs. 139.2 mmol/L, P   24 h (97.4% vs. 59.6%, P   38.5 ˚C (47.4% vs. 11.0%, P   62 mg/L (26% vs. 2%, P  Conclusion Hyponatremia is a novel and very discriminative marker of complicated appendicitis in the pediatric population, and is therefore recommended in appendicitis diagnostic and treatment planning. Type of study Prospective comparative study Level of evidence II