A New Marker In The Diagnosis Of Acute Complicated Appendicitis In Adult Patients: Neutrophil/Albumin Ratio

Abstract

ABSTRACT
 Aim: Our study aims to search the effectiveness of neutrophil/albumin ratio (NAR) in distinguishing between acute appendicitis (AA) and acute complicated appendicitis (ACA) and to find the best cut-off point of neutrophil/albumin ratio (NAR) for the diagnosis of ACA.
 Material and method: This study was performed using data from 453 adult patient who underwent appendectomy and divided into two groups as AA and ACA. Demographic data, preoperative white blood cell count (WBC), neutrophil lymphocyte ratio (NLR), neutrophil/albumin ratio (NAR), C-reactive protein value (CRP) surgical outcomes, and pathological outcomes were retrospectively assessed for each groups.
 Results: In our study, 362 patients were in the AA group and 91 patients were in the ACA group. WBC, NLR, CRP and NAR were significant parameters in differentiating acute appendicitis from acute complicated appendicitis. Among these parameters, NAR; AUROC sensitivity and specificity values were stronger than others. (AUROC: 0.963, sensitivity: 95.6%, specificity: 85.7%). As a result of the ROC curve analysis, a cut-off value of 2.79 mg/dl was found. 
 Conclusion: NAR is a novel inflammatory marker simply detected through routine preoperative blood results, with no additional time or cost. The neutrophil/albumin ratio (NAR) is a fast, easy to access and reliable parameter to differentiate AA from ACA.