The Predictive Value of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratio for Diagnosis of Acute Appendicitis and Distinguishing Between Complicated and Uncomplicated Appendicitis at King Abdul-Aziz Medical City-Jeddah
DOI:
https://doi.org/10.63278/10.63278/mme.v31.1Abstract
Background: The study aimed to evaluate the predictive value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in diagnosing acute appendicitis and distinguishing between complicated and uncomplicated cases at King Abdul-Aziz Medical City-Jeddah.
Methods: This retrospective cohort study reviewed data from adult patients who underwent appendectomy between 2018 and 2023. Data were collected from electronic medical records and included demographic information, clinical presentation, laboratory results (including NLR, PLR, CRP, and total bilirubin levels), surgical history, and histopathological findings. Statistical analysis involved descriptive statistics, Chi-squared test (χ2), and Mann-Whitney tests to compare variables between groups, with significance set at p < 0.05.
Results: The study included 387 participants with a mean age of 33.4 ± 12.78 years, ranging from 18 to 98 years. The cohort was predominantly male (223 males, 57.6%). The most common clinical sign was right lower quadrant tenderness (332 participants, 85.8%). Blood tests showed a mean total bilirubin level of 14.88 ± 10.82, mean WBC 12.73 ± 5.49 with mean neutrophil 9.18 ± 4.05. Mean platelet count was 287.96 ± 118.05. The mean NLR was 6.65 ± 5.87, and the mean PLR was 186.86 ± 115.67. NLR and PLR were significantly higher among complicated appendicitis with (p=<0.01) and (p=<0.05) respectively. Approximately half of the participants had a modified Alvarado score of 4-6 (49.1%). Most patients (359, 92.8%) underwent laparoscopic appendectomy. The majority of hospital stays were under one week (368 participants, 95.1%). Complications were reported in 16 participants, including infections (7 cases), perforation (1 case), bleeding (1 case), abdominal collection (3 cases), pelvic collection and abscess (2 cases), ileus (1 case), sepsis and pulmonary embolism (1 case).
Conclusion: NLR and PLR demonstrated a significant relationship and effectively differentiate between complicated and uncomplicated appendicitis. However, further studies are still needed to refine diagnostic tools for appendicitis.
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