The relationship between interleukin-8 levels and appendicitis in children: a cross-sectional study

Abstract

Background and objectives. Differentiating simple from complicated pediatric acute appendicitis remains challenging. Interleukin-8 (IL-8) has been proposed as a potential severity biomarker. This study evaluated the association between preoperative serum IL-8 levels and clinical severity in pediatric acute appendicitis. Materials and methods. This cross-sectional study included 34 pediatric patients undergoing appendectomy at a tertiary center. Perforation was defined based on combined intraoperative findings and histopathological grading. Preoperative serum IL-8 levels were measured using ELISA. Due to the non-normal distribution of IL-8 values, data were analyzed using the Mann-Whitney U and Kruskal-Wallis tests, including a sensitivity analysis for imbalanced Pediatric Appendicitis Score (PAS) subgroups (PAS ≤6 vs. PAS ≥7). Results. The cohort had a median age of 11.5 years, and the perforation rate was 61.8%. The overall median IL-8 level was 43.34 pg/mL (IQR: 10.12-1123.88). Although median IL-8 levels were higher in perforated than in non-perforated cases (143.90 vs. 10.87 pg/mL; p = 0.073) and increased across PAS categories (PAS 5-6: 11.54 pg/mL; PAS 9-10: 1994.68 pg/mL; p = 0.360), these trends did not reach statistical significance. Sensitivity analysis comparing PAS ≤6 and PAS ≥7 also yielded non-significant results (p = 0.296). Conclusions. In this exploratory study, serum IL-8 showed an upward trend with increasing clinical severity and perforation status. However, because these associations did not reach statistical significance, the findings should be interpreted strictly as hypothesis-generating. The results suggest that systemic IL-8 may reflect localized inflammatory burden rather than serve as a standalone predictive clinical tool. Adequately powered studies incorporating multivariable modeling are required to evaluate its potential value in combination with clinical and laboratory parameters.

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