The Role of Preoperative HALP Score in Differentiating Complicated Acute Appendicitis

NCT07002671 | Completed

• 1 other identifier: 2025/9-8
• Study Type: observational
• Target: 411
• Locations: 1 country
• Sites: 1

Brief Summary

Acute abdomen is a frequently encountered clinical condition that can be fatal if not diagnosed early. Acute appendicitis is one of the causes of acute abdomen and is the most common clinical condition leading to acute abdomen worldwide. Therefore, early diagnosis is crucial. Delays in diagnosis can lead to the complication of appendicitis and an increase in its complications, further worsening the clinical picture and raising morbidity and mortality rates. In patients diagnosed with acute appendicitis, distinguishing between complicated and uncomplicated appendicitis is vital for treatment planning. The evaluation of patients' laboratory and radiological findings are widely used methods in clinical practice for this differentiation. Recent studies have shown the HALP score has become a new prognostic biomarker in the literature, used to predict a range of clinical outcomes in various neoplasms. To date, the HALP score has been used to evaluate outcomes and prognosis in gastric, colorectal, bladder, prostate, and other cancers, as well as in many other diseases. The purpose of this study is to determine the clinical impact of using the preoperatively calculated HALP score, derived from blood parameters, in the diagnosis, detection, and treatment of complicated acute appendicitis cases in the preoperative period without the need for additional diagnostic methods.

Conditions

Acute Appendicitis; Acute Appendicitis Without Peritonitis; Acute Appendicitis With Appendix Abscess; Acute Appendicitis With Rupture

Keywords

Acute Appendicitis; Complicated Acute Appendicitis; Uncomplicated Acute Appendicitis; HALP Score

Outcome Measures

Primary Outcomes (1)

• Preoperative HALP Score

  Manually calculated HALP score from routinely obtained preoperative blood samples of acute appendicitis cases, can be helpful for preoperatively determining complicated acute appendicitis cases without additional cost.

  2020,01,01-2025,01,01

Secondary Outcomes (1)

• Preoperative cut off value levels of HALP score to determine complicated acute appendicitis

  2020,01,01-2025,01,01

Study Arms (2)

Complicated acute appendicitis cases

Acute appendicitis cases with pathological diagnosis of gangrenous, phlegmonous, perforated or presence of perforation, abscess or plastron in surgical exploration

Procedure: Appendectomy; Diagnostic Test: blood sampling

Uncomplicated acute appendicitis cases

Acute appendicitis cases without pathological diagnosis of gangrenous, phlegmonous, perforated or presence of perforation, abscess or plastron in surgical exploration

Procedure: Appendectomy; Diagnostic Test: blood sampling

Interventions

Appendectomy PROCEDURE

Appendectomy (Laparoscopic or conventional open surgery)

Also known as: Laparoscopic Appendectomy, Conventional Open Appendectomy

Complicated acute appendicitis cases; Uncomplicated acute appendicitis cases

blood sampling DIAGNOSTIC_TEST

Blood samples, in the preoperative period, routinely collected from the patients of acute appendicitis cases

Complicated acute appendicitis cases; Uncomplicated acute appendicitis cases

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Patients operated diagnosed as acute appendicitis.

You may qualify if:

• Being over 18 years of age
• Having undergone surgical treatment for a diagnosis of acute appendicitis (Laparoscopic or conventional open surgery)
• Patients with no missing data in their records

You may not qualify if:

• Patients under 18 years of age
• Cases of uncomplicated acute appendicitis diagnosed but treated medically
• Patients with incomplete data
• Those with chronic kidney and liver failure
• Patients with liver diseases such as Wilson's disease or alpha-1 antitrypsin deficiency
• Individuals with hematological malignancies like ALL or AML
• Patients with genetic bleeding disorders such as hemophilia

Sponsors & Collaborators

• Kahramanmaras Sutcu Imam University: lead
• Elazıg Fethi Sekin Sehir Hastanesi: collaborator

Study Sites (1)

Elazığ Fethi Sekin City Hospital

Elâzığ, 23100, Turkey (Türkiye)

Location

Related Publications (9)

• Kirkil C, Karabulut K, Aygen E, Ilhan YS, Yur M, Binnetoglu K, Bulbuller N. Appendicitis scores may be useful in reducing the costs of treatment for right lower quadrant pain. Ulus Travma Acil Cerrahi Derg. 2013 Jan;19(1):13-9. doi: 10.5505/tjtes.2013.88714.

  PMID: 23588973 BACKGROUND

• Kirkil C, Yigit MV, Aygen E. Long-term results of nonoperative treatment for uncomplicated acute appendicitis. Turk J Gastroenterol. 2014 Aug;25(4):393-7. doi: 10.5152/tjg.2014.7192.

  PMID: 25254521 BACKGROUND

• Bozan MB, Yazar FM, Boran OF, Guler O, Azak Bozan A. Are the immature granulocyte count and percentage important in continue medical treatment in acute appendicitis? A prospective, randomized, and controlled study. Ulus Travma Acil Cerrahi Derg. 2022 Jul;28(7):979-987. doi: 10.14744/tjtes.2021.76307.

  PMID: 35775679 BACKGROUND

• Guler O, Bozan MB, Alkan Baylan F, Oter S. The Utility of Immature Granulocyte Count and Percentage on the Prediction of Acute Appendicitis in the Suspected Acute Appendicitis According to the Alvarado Scoring System: A Retrospective Cohort Study. Turk J Gastroenterol. 2022 Oct;33(10):891-898. doi: 10.5152/tjg.2022.21865.

  PMID: 35946881 BACKGROUND

• Zhang Y, Zhao YY, Qiao J, Ye RH. Diagnosis of appendicitis during pregnancy and perinatal outcome in the late pregnancy. Chin Med J (Engl). 2009 Mar 5;122(5):521-4.

  PMID: 19323901 BACKGROUND

• Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol. 1990 Nov;132(5):910-25. doi: 10.1093/oxfordjournals.aje.a115734.

  PMID: 2239906 BACKGROUND

• Khanapure S, Nagral S, Nanavati AJ. A study of events between the onset of symptoms and hospital admission in patients with acute abdomen. Natl Med J India. 2017 Mar-Apr;30(2):65-68.

  PMID: 28816211 BACKGROUND

• Bokemeyer A, Ochs K, Fuhrmann V. [Acute Abdomen: Diagnostic Management]. Dtsch Med Wochenschr. 2020 Oct;145(21):1544-1551. doi: 10.1055/a-1007-4264. Epub 2020 Oct 20. German.

  PMID: 33080641 BACKGROUND

• Ag O, Kutluer N, Ogut MZ, Azak Bozan A, Ebiloglu MF, Gunes B, Ayyildiz H, Bozan MB. The Importance of Preoperatively Calculated Halp Score in Differentiating Complicated Acute Appendicitis in Patients With Acute Appendicitis. World J Surg. 2026 Jan;50(1):121-129. doi: 10.1002/wjs.70160. Epub 2025 Nov 25.

  PMID: 41291390 DERIVED

MeSH Terms

Conditions

Appendicitis

Interventions

Appendectomy; Blood Specimen Collection

Condition Hierarchy (Ancestors)

Intraabdominal Infections; Infections; Gastroenteritis; Gastrointestinal Diseases; Digestive System Diseases; Cecal Diseases; Intestinal Diseases

Intervention Hierarchy (Ancestors)

Digestive System Surgical Procedures; Surgical Procedures, Operative; Specimen Handling; Clinical Laboratory Techniques; Diagnostic Techniques and Procedures; Diagnosis; Punctures; Investigative Techniques

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor, Associate

Study Record Dates

• First Submitted: May 25, 2025
• First Posted: June 3, 2025
• Study Start: January 1, 2020
• Primary Completion: January 1, 2025
• Study Completion: May 20, 2025
• Last Updated: June 26, 2025

Record last verified: 2025-06

Locations

TU (1)