Neutrophil to lymphocyte ratio in diagnosis of complicated and non-complicated appendicitis

Abstract

Introduction: Acute appendicitis is one of the most common surgical problems of childhood. Late or misdiagnosis may increase the morbidity and mortality of this condition. Objective: To test the utility of some laboratory methods, especially Neutrophil/Lymphocyte (N/L) ratio in rapid diagnosis of simple and complicated acute appendicitis Method: The records of 498 cases hospitalized in paediatric surgery departments in Turkey between the years 2008 and 2014 with the suspicion or pre-diagnosis of acute appendicitis were retrospectively evaluated. Among these, 279 were diagnosed as non-complicated appendicitis while 73 were diagnosed as complicated appendicitis. The remaining 146 cases without the appendectomy requirement comprised the control group. Clinical, haematologic and radiologic data of all cases were investigated. Results: Among the patients who had appendectomy, 214 (60.8%) were male. The mean age of the patients was 9.8 ± 3.5 years. The mean C-reactive protein (CRP) (46.6±54.1 vs. 17.3±17.1, p=0.048), white blood cell count (WBC) (18.2±4.8 vs. 10.3±4.6, p 3 and CRP value greater than 15 mg/dl were significantly higher than the non-complicated group (65.8% vs. 34.3%, p=0.035 and 67.1% vs. 32.9%, p=0.046, respectively). In diagnosis of complicated acute appendicitis, the cut off value for N/L was determined as 7.2 (p=0.017) (Sensitivity 83.6%, specificity 69.6%). Conclusions: In our study the most appropriate cut off value of N/L in differentiating complicated acute appendicitis from non-complicated appendicitis was 7.2. In our study, WBC>12x10 3 and CRP>15 mg/dl values were important parameters distinguishing complicated appendicitis from non-complicated one. Sri Lanka Journal of Child Health, 2017; 46 : 59-65