The Change of Neutrophil Lymphocyte Ratio in Acute Appendicitis

Abstract

Abstract Acute appendicitis is the most common indication for emergency abdominal surgery, although it remains difficult to diagnose. Aim of this study is to investigate the supporting role of neutrophil/lymphocyte ratio in diagnosis of acute appendicitis. The medical records of 241 patients who had undergone appendectomy between June 2013 and March 2014 were investigated retrospectively. Sixty patients who had undergone at least one complete blood count during preoperative hospital admission and who had no other active inflammatory conditions at the time the sample was taken were included in the study. Neutrophil/lymphocyte ratio and leukocyte count values were determined in each patient at hospital admission and during active acute appendicitis. Age, sex, neutrophil/lymphocyte ratio and leukocyte counts were recorded for each patient. The mean age of the patients was 33.15±10.94 years; male to female ratio was 1.5:1. Mean leukocyte count was significantly higher in acute appendicitis group (13.14±2.99×10 3 /mm 3 ) than control group (7.42±2.12×10 3 /mm 3 ) (p=0.01). The best cutoff point for leukocyte count was 10.10×10 3 /mm 3 , with sensitivity of 94% and a specificity of 75%. Mean neutrophil/lymphocyte ratio was significantly higher in acute appendicitis group (5.47±3.24) than control group (1.99±1.11) (p=0.02). The best cutoff point for neutrophil/lymphocyte ratio was 1.73, with sensitivity of 97% and a specificity of 87%. Area under receiver operating characteristic curve was 0.67 for leukocyte count and 0.60 for neutrophil/lymphocyte ratio. Neutrophil/lymphocyte ratio was significantly higher in acute appendicitis and can be used as a supportive diagnostic parameter in the diagnosis of acute appendicitis. Key Words: Acute appendicitis, neutrophil/lymphocyte ratio, diagnosis.