Evaluation of laboratory parameters in the diagnosis of acute appendicitis

Abstract

Abstract Introduction The aim of this prospective study was to investigate the diagnostic value of the fibrinogen level, platelet (PLT) count, mean platelet volume (MPV), lymphocyte count, neutrophil/lymphocyte ratio (NLR) and C-reactive protein (CRP) level with white blood cell (WBC) and neutrophil count in acute appendicitis (AA). Methods One hundred and ninety-seven patients who were admitted with the findings of acute abdomen and operated on with a preoperative diagnosis of AA were included in this prospective observational study. After surgery, according to the histopathological results of the appendix, patients were classified as Group 1; with normal histology of appendix vermicularis, Group 2; patients with positive histology for appendicitis with or without perforation, periappendiceal abscess, suppurative, gangrenous or ulcerophlegmonous appendicitis. Results In the comparison of the two groups, the difference between CRP and MPV were insignificant (p=0.12 and p=0.09, respectively). WBC, neutrophil count, NLR were significantly higher in Group 2 (p<0.001 for each), whereas fibrinogen levels, lymphocyte count and the PLT counts were significantly higher in Group 1 (p=0.03, 0.002 and 0.003, respectively). Discussion and conclusion WBC, neutrophil and NLR are predictive for the diagnosis of AA, whereas elevated levels of fibrinogen, high lymphocyte and PLT count are predictive for non-appendicial pathology with low diagnostic accuracies.