Background: Pediatric acute appendicitis (PAA) involves a substantial consumption of health and economic resources. The identification of serum biomarkers that may help predict the post-surgical evolution of these patients is a field of great interest. Patients and Methods: This was a prospective, observational substudy within the Biomarkers for the Diagnosis of Appendicitis in Pediatrics (BIDIAP) cohort aimed at evaluating the association between post-surgical increase in serum IL-6 and different outcomes related to the clinical evolution of children operated on for PAA. Sixty-nine children with a confirmed diagnosis of acute appendicitis and both pre-operative and post-operative serum IL-6 were included in the study. Three multivariable-adjusted linear regression models were fitted to analyze the association between an increase of >10% in post-operative serum IL-6 level with the length of stay, the number of post-operative emetic episodes, and the onset of oral feeding. Two multivariable-adjusted logistic regression models were fitted to assess the association of the same exposure with the indication of antibiotherapy at discharge and with positivity in peritoneal fluid culture. Results: Thirteen children showed an increase of >10% in the post-operative serum IL-6 value (group 1) whereas 56 showed only a minor increase, or no change (group 2). After accounting for potential confounders, children in group 1 had a mean of three-day longer hospital stay (difference, 3.33; 95% confidence interval [CI], 0.57-6.09) and higher odds of a positive result in peritoneal fluid culture (odds ratio [OR], 37.43; 95% CI, 1.02-1361.28) than children in group 2. Conclusions: An increase of >10% in post-operative serum IL-6 value could predict longer hospital stay and higher odds of positive peritoneal fluid culture. Future prospective studies are needed to replicate these findings and to broaden the range of biomarkers that could predict the post-operative evolution of children operated on for PAA.

中文翻译：

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急性阑尾炎手术儿童的术后血清白细胞介素 6 升高与住院时间延长相关：一项试点研究。

背景：小儿急性阑尾炎（PAA）涉及大量的健康和经济资源消耗。血清生物标志物的鉴定可能有助于预测这些患者的术后演变，这是一个令人非常感兴趣的领域。患者和方法：这是儿科阑尾炎诊断生物标志物 (BIDIAP) 队列中的一项前瞻性、观察性子研究，旨在评估手术后血清 IL-6 升高与儿童临床演变相关的不同结果之间的关系。为 PAA 进行手术。该研究纳入了 69 名确诊为急性阑尾炎且术前和术后血清 IL-6 的儿童。拟合了三个多变量调整线性回归模型来分析术后血清 IL-6 水平增加 >10% 与住院时间、术后呕吐次数和经口喂养开始之间的关联。拟合了两个多变量调整逻辑回归模型来评估相同暴露与出院时抗生素治疗指征以及腹膜液培养阳性的关联。结果：13 名儿童术后血清 IL-6 值增加了 >10%（第 1 组），而 56 名儿童仅出现轻微增加或没有变化（第 2 组）。考虑到潜在的混杂因素后，第 1 组儿童的平均住院时间延长了三天（差异为 3.33；95% 置信区间 [CI]，0.57-6.09），并且腹膜液培养呈阳性结果的几率更高（几率为比值[OR], 37.43; 95% CI, 1.02-1361.28)高于第2组儿童。结论：术后血清IL-6值增加>10%可以预测住院时间更长和腹膜液阳性的几率更高文化。未来的前瞻性研究需要复制这些发现，并扩大可以预测接受 PAA 手术的儿童术后演变的生物标志物的范围。