Ulus Travma Acil Cerrahi Derg. 2014; 20(1): 19-22 | DOI: 10.5505/tjtes.2014.20688

Neutrophil-to-lymphocyte ratio as a predictor of acute appendicitis

Þahin Kahramanca¹, Gülay Özgehan¹, Duray Þeker¹, Emre Ýsmail Gökce¹, Gaye Þeker¹, Gündüz Tunç², Tevfik Küçükpýnar¹, Hülagü Kargýcý^1
1Diskapi Yildirim Beyazit Teaching And Research Hospital General Surgery Clinic, Ankara, Turkey
²Acibadem Hospital, Ankara, Turkey

BACKGROUND: Accurately diagnosing appendicitis can be difficult. This retrospective study aimed to evaluate the ability of the neutrophil-to-lymphocyte ratio (NLR) to predict acute appendicitis pre-operatively and to differentiate between simple and complicated appendicitis.
METHODS: A database of 1067 patients who underwent surgery was evaluated. Based on postoperative histopathological examination, the patients were divided into two groups: acute appendicitis (G1) and normal appendix (G2). Patients in the acute appendicitis group were further divided into two subgroups: simple appendicitis (G1a) and complicated (gangrenous and perforated) appendicitis (G1b).
RESULTS: G1 included 897 patients and G2 included 170 patients. Among the 897 G1 patients, there were 753 G1a patients and 144 G1b patients. A NLR of 4.68 was associated with acute appendicitis (G1 vs G2, p<0.001). The sensitivity and specificity were 65.3% and 54.7%, respectively. A NLR of 5.74 was associated with complicated appendicitis (G1a vs G1b, p<0.001). The sensitivity and specificity of the two clinical features were 70.8% and 48.5%, respectively.
CONCLUSION: We suggest that preoperative NLR is a useful parameter to aid in the diagnosis of acute appendicitis and differentiate between simple and complicated appendicitis, and can be used as an adjunct to the clinical examination.

Keywords: Appendicitis, complicated appendicitis; lymphocyte; neutrophil.

---

Nötrofil/lenfosit oranýnýn akut apandisit tanýsýndaki belirleyiciliði

Þahin Kahramanca¹, Gülay Özgehan¹, Duray Þeker¹, Emre Ýsmail Gökce¹, Gaye Þeker¹, Gündüz Tunç², Tevfik Küçükpýnar¹, Hülagü Kargýcý^1
1Dýþkapý Yýldýrým Beyazýt Eðitim Ve Araþtýrma Hastanesi Genel Cerrahi Kliniði, Ankara, Türkiye
²Acýbadem Hastanesi, Ankara, Türkiye

AMAÇ: Akut apandisitin tanýsý zor olabilmektedir. Bu retrospektif çalýþmada, nötrofil/lenfosit oranýnýn (NLR) akut apandisit tanýsýndaki ve komplike apandisit ile basit apandisit ayrýmýndaki belirleyiciliði araþtýrýldý.
GEREÇ VE YÖNTEM: Akut apandisit tanýsý ile ameliyat edilmiþ 1067 hastanýn kayýtlarý retrospektif olarak incelendi. Histopatolojik deðerlendirmeye göre hastalar akut apandisit (G1) ve normal appendiks (G2) olarak iki ana gruba ayrýldý. Akut apandisit grubundaki hastalar ise yeniden basit apandisit ve komplike (perfore ve gangrene) olarak alt iki gruba ayrýldý.
BULGULAR: G1 grubunda 897, G2 grubunda 170 hasta vardý. G1a’da 753, G1b’de ise 144 hasta vardý. Akut apandisit tanýsý konulmasýnda NLR için cut-off deðeri 4.68 (p<0.001) olarak hesaplandý. Sensitivite %65.3, spesifite ise %54.7 idi. Komplike apandisit ayýrýmý için NLR cut-off deðeri 5.74 olarak hesaplandý. Sensitivitesi %70.8, spesifitesi ise %48.5 idi.
TARTIÞMA: Akut apandisit tanýsýnýn konulmasýnda ve komplike apandisit ayrýmýnda NLR klinik deðerlendirmeye ek olarak faydalý bir parametredir.

Anahtar Kelimeler: Apandisit, komplike apandisit; lenfosit; nötrofil.

---

CITE