Neutrophil to lymphocyte ratio in diagnosis of complicated and noncomplicated appendicitis
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Dosyalar
Tarih
2017
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Sri Lanka College of Paediatricians
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
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 prediagnosis 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 < 0.001), polymorphonuclear leucocyte (14.5±4 vs. 7.3±4.6, p < 0.001) and N/L (8.4±6 vs. 4.4±3.8, p=0.024) values of the patients who had appendectomy were significantly higher. In diagnosis of acute appendicitis, the cut off value for N/L was determined as 5 (p=0.003) (Sensitivity 72.7%, specificity 67.8%). Among complicated acute appendicitis cases, N/L value was significantly higher (10.9±7.2 vs. 6.7±3.3, p=0.04), and the number of patients with WBC greater than 12x103 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 > 12x103 and CRP > 15 mg/dl values were important parameters distinguishing complicated appendicitis from non-complicated one.
Açıklama
Anahtar Kelimeler
Child, Complicated appendicitis, Neutrophil to lymphocyte ratio, Non-complicated appendicitis
Kaynak
Sri Lanka Journalof Child Health
WoS Q Değeri
Scopus Q Değeri
Q4
Cilt
46
Sayı
1
