{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T10:10:35Z","timestamp":1773655835879,"version":"3.50.1"},"reference-count":49,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T00:00:00Z","timestamp":1773446400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathophysiology"],"abstract":"<jats:p>Background\/Objectives: Sex and age influence inflammatory responses, but researchers have not fully characterized their combined association with complicated acute appendicitis (CAA). This study assessed the independent and interactive associations of sex, age, and inflammatory cell counts with CAA. Methods: We conducted a retrospective observational study of 708 patients with histopathologically confirmed uncomplicated appendicitis (UAA) or CAA. We analyzed demographic and clinical data, including preoperative complete blood counts, stratified by sex. We used multivariable logistic regression models with interaction terms to evaluate associations and possible effect modification by sex and age. We explored the direction and magnitude of these interactions by estimating marginal predicted probabilities. Results: The incidence of CAA was significantly higher in men than in women. In men with CAA, complete blood count analysis showed elevated neutrophil and monocyte counts and reduced lymphocyte counts. Male sex (odds ratio (OR) 2.197, 95% confidence interval (CI) 1.610\u20132.999), continuous age (1.017, 1.002\u20131.033), lymphocyte count (0.656, 0.526\u20130.820), monocyte count (1.551, 1.036\u20132.321), and platelet count (1.004, 1.001\u20131.006) were independently associated with CAA. Interaction analysis revealed significant interactions between neutrophils and both sex and age (p &lt; 0.05), while lymphocyte counts showed significant interaction with age but not with sex. Conclusions: This study provides new insight into complex sex- and age-related immune cell patterns in CAA and may inform future diagnostic and management strategies by highlighting immune profile variability.<\/jats:p>","DOI":"10.3390\/pathophysiology33010022","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T08:41:26Z","timestamp":1773650486000},"page":"22","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Sex, Age, and Inflammatory Cell Counts with Complicated Acute Appendicitis"],"prefix":"10.3390","volume":"33","author":[{"given":"Said Jos\u00e9","family":"Serrano Guzm\u00e1n","sequence":"first","affiliation":[{"name":"Divisi\u00f3n de Cirug\u00eda, Hospital B\u00e1sico Comunitario de R\u00edo Grande Villa de Tututepec, Instituto Mexicano del Seguro Social para el Bienestar, Oaxaca 71830, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos Leyber","family":"Vargas Ju\u00e1rez","sequence":"additional","affiliation":[{"name":"Facultad de Sistemas Biol\u00f3gicos e Innovaci\u00f3n Tecnol\u00f3gica, Universidad Aut\u00f3noma \u201cBenito Ju\u00e1rez\u201d de Oaxaca, Oaxaca 68120, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcos","family":"Hern\u00e1ndez G\u00f3mez","sequence":"additional","affiliation":[{"name":"Divisi\u00f3n de Cirug\u00eda, Hospital Cruz Azul, Oaxaca 70380, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Roberto","family":"Luis V\u00e1squez","sequence":"additional","affiliation":[{"name":"Divisi\u00f3n de Cirug\u00eda, Hospital General San Pedro Pochutla, Oaxaca 70900, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2412-0360","authenticated-orcid":false,"given":"Sergio Roberto","family":"Aguilar Ruiz","sequence":"additional","affiliation":[{"name":"Facultad de Medicina y Cirug\u00eda, Universidad Aut\u00f3noma \u201cBenito Ju\u00e1rez\u201d de Oaxaca, Oaxaca 68120, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Carlos","family":"Ramos Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Unidad M\u00e9dica de Alta Especialidad UMAE Yucat\u00e1n, Ignacio Garc\u00eda T\u00e9llez, Yucat\u00e1n 97155, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joscelin Amaranta","family":"Mac\u00edas R\u00edos","sequence":"additional","affiliation":[{"name":"Divisi\u00f3n de Medicina Interna, Hospital General \u201cDr. Aurelio Valdivieso\u201d, Instituto Mexicano del Seguro Social Para el Bienestar, Oaxaca 68050, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3985-3628","authenticated-orcid":false,"given":"Edgar Gustavo","family":"Ramos Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Facultad de Medicina y Cirug\u00eda, Universidad Aut\u00f3noma \u201cBenito Ju\u00e1rez\u201d de Oaxaca, Oaxaca 68120, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9213-553X","authenticated-orcid":false,"given":"Jos\u00e9 Luis","family":"Cano P\u00e9rez","sequence":"additional","affiliation":[{"name":"Facultad de Sistemas Biol\u00f3gicos e Innovaci\u00f3n Tecnol\u00f3gica, Universidad Aut\u00f3noma \u201cBenito Ju\u00e1rez\u201d de Oaxaca, Oaxaca 68120, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jes\u00fas David","family":"Guzm\u00e1n Ortiz","sequence":"additional","affiliation":[{"name":"Divisi\u00f3n de Cirug\u00eda, Hospital General \u201cDr. Aurelio Valdivieso\u201d, Instituto Mexicano del Seguro Social Para el Bienestar, Oaxaca 68050, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha Silvia","family":"Mart\u00ednez Luna","sequence":"additional","affiliation":[{"name":"Divisi\u00f3n de Cirug\u00eda, Hospital General \u201cDr. Aurelio Valdivieso\u201d, Instituto Mexicano del Seguro Social Para el Bienestar, Oaxaca 68050, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3114-4571","authenticated-orcid":false,"given":"Leticia Lorena","family":"Hern\u00e1ndez Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Facultad de Sistemas Biol\u00f3gicos e Innovaci\u00f3n Tecnol\u00f3gica, Universidad Aut\u00f3noma \u201cBenito Ju\u00e1rez\u201d de Oaxaca, Oaxaca 68120, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3060","DOI":"10.1007\/s00268-023-07183-2","article-title":"Factors contributing to delays to accessing appendectomy in low- and middle-income countries: A scoping review","volume":"47","author":"Louw","year":"2023","journal-title":"World J. 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