Diagnostic value of basic laboratory parameters for simple and perforated acute appendicitis

Abstract

Aim: The aim of the present study was to investigate the efficacy of simple laboratory parameters including neutrophil-to-lymphocyte ratio (NLR), leukocyte count (WCC), C-reactive protein (CRP) and red cell distribution width (RDW) values in both diagnosing simple appendicitis and predicting complicated appendicitis.Material and Methods: A database of 413 patients who underwent surgery was appreciated. Based on postoperative histopathological examination, the patients were divided into two groups: negative appendectomy (G1) and positive appendectomy (G2). Patients in the positive appendectomy group were further divided into two subgroups: simple appendicitis (G2a) and complicated (gangrenous and perforated) appendicitis (G2b).Results: WCC and NLR were significant parameters for the diagnosis of acute appendicitis. Cut-off values were 11950/mm3 for WCC (sensitivity: 71.7%; specificity: 50%; OR: 2.53) and 3.7 for NLR (sensitivity: 75.1%; specificity: 42.8%; OR:2.25). WCC, CRP and NLR were independent variables for the diagnosis of complicated appendicitis. Cut-off values were 14450/mm3 for WCC (sensitivity: 66.7%; specificity: 59%; OR: 2.87), 25.5 mg/dl for CRP (sensitivity: 63.8%; specificity: 58.2%; OR: 2.47) and 6.94 for NLR (sensitivity: 61.1%; specificity: 61%; OR: 2.51). Conclusion: As a result, 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.