CAN RAPIDLY PROGRESSIVE ACUTE APPENDICITIS BE PREDICTED IN CHILDREN USING STANDARD TESTS?

Abstract

Aim. To predict rapidly progressive appendicitis using routinely performed tests. Methods. We have analysed patients’ records from the Paediatric Surgery departments in two hospitals with acute appendicitis for a 19­year period. The early uncomplicated appendicitis (A1) group was compared to the late uncomplicated – or resolving appendicitis (A2) group. Also, the early complicated – or as we called it­ rapidly progressive appendicitis (B1) group was compared to the late complicated appendicitis (B2) group. Results. A2 in comparison to A1 showed a lower median white blood cell count 12.3×109/l, neutrophil 74.6 % and neutrophil­to­lymphocyte ratio (NLR) 4.3, p < 0.0001 but a higher CRP 20 mg/l, p < 0.0001. B1 showed a higher median Basophil count 0.068×109/l, p < 0.0001, but a lower CRP 17 mg/l, p = 0.003 than B2. Conclusions. A higher basophil count and CRP may suggest a rapidly progressive appendicitis, while a lower White blood cell count, neutrophil percentage and NLR may predict resolving appendicitis.