Kadar Asam Folat Darah dalam Memprediksi Apendisitis Komplikata pada Pasien Anak

Abstract

Background: Appendicitis is the most common surgical emergency in children. Nearly 30% of children present with complicated appendicitis. A study conducted with animal models indicates that lower folate levels were associated with a higher likelihood of complicated appendicitis. Another study suggested that folate levels could be a significant predictive factor for the occurrence of complicated appendicitis in animal models. Objective: The aim of this study is to analyze the level of folic acid in pediatric patient with appendicitis as a predictor of complicated appendicitis. Method: This study is a prospective cohort study with observational analytical approach involving serological blood tests and histopathological examination of pediatric patients with appendicitis from October 2022 to March 2023. Subject involved nine pediatric patients who were then grouped and upon admission, underwent folic acid measurement, and later intervented surgically with either appendectomy or laparatomy. Kruskal-Willis test and Spearman test would be performed. Result: Kruskal-Wallis test showed no significant difference in folic acid levels among the three groups based on the onset of symptoms (p>0.05). Spearman correlation test showed a moderate negative correlation (r = -0.609) between the onset of symptoms and folate levels in pediatric appendicitis patients, but it was not statistically significant (p > 0.05). From the R2 value, it can be inferred that folate levels can predict 53% of the onset of symptoms. Conclusion: Future research should assess relationship with other risk factors with increased number of subjects and cut-off value for folic acid as a predictor should also be established.