Does neutrophil lymphocyte ratio have a clinical value to determine the seriousness of the acute appendicitis cases?

Aim: The aim of our study is to investigate the predictive value of the neutrophil lymphocyte ratio (NLR) assessed in the emergency department to distinguish complicated and uncomplicated acute appendicitis (AA) cases.

Method: In our study, the files of the AA cases who visited our emergency clinic between 01.06.2015 and 01.01.2016 and then were operated in our hospital were reviewed retrospectively. The age, gender, the imaging method performed in the emergency clinic with an AA preliminary diagnosis, the result of the radiologic report in terms of AA and histopathological examination results were recorded according to the patient records. The patients were divided into two groups such as complicated AA (Group 1) and uncomplicated AA (Group 2) based on their histopathological analysis results. The laboratory parameters of the patients, which were seen within the first 30 minutes after they visit the emergency clinic, were examined.

Result: 121 of the 154 patients who were involved in the study were in Group 1 and 33 of the patients were in Group 2. A statistically significant difference was found between two groups in terms of the number of white blood cells (WBC) and NLR (p=0,000). The cut-off value for NLR in the complicated AA distinction was detected as 7,3 (75.8% sensitivity, 81.8% selectivity).

Conclusion: As an easy and effective analysis method, we think that NLR might be a good guide for to diagnose complicated AA cases quickly.