Publication: Predicting Complicated Appendicitis Based on Neutrophil to Lymphocyte Ratio, A Study in University Hospital of Nepal
Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Acute appendicitis is one of the most common causes of acute abdomen requiring
surgical treatment. Accurately diagnosing appendicitis and identifying complicated
appendicitis can be difficult at times.
Objective
To evaluate the ability of the neutrophil-to-lymphocyte ratio (NLR) to differentiate
between uncomplicated and complicated appendicitis.
Method
This was a prospective hospital-based observational study conducted at the
Department of Surgery, Dhulikhel Hospital, Kathmandu University Hospital from July
2021 to December 2022. Patients with the clinical diagnosis of acute appendicitis
who had undergone emergency appendectomy were included in the study. Informed
consent was taken from each patient and data collection was done by filling the
proforma.
Result
A total of 218 patients were included in the study. Male: female ratio was 1.18:1.
Mean age of patients was 28.58 ± 16.65 (3-78) years. A significant correlation was
found between increasing neutrophil count and neutrophil-to-lymphocyte ratio with
complicated appendicitis. However, no significant correlation was found between
White Blood Cell counts and complicated appendicitis. Neutrophil-to-lymphocyte
ratio > 12.6 was found to be associated with complicated appendicitis.
Conclusion
A simple, cost-effective, and yet perfect test is not available for identifying
complicated appendicitis. Increased Neutrophil count and neutrophil-to-lymphocyte
ratio can indicate complicated appendicitis. Elevated WBC counts alone has no role
in differentiating complicated appendicitis. According to the results of our study, an
neutrophil-to-lymphocyte ratio of 12.6 can help to differentiate complicated from
uncomplicated appendicitis.
KEY WORDS
Appendectomy, Appendicitis, Lymphocyte count, Neutrophils, Receiver operating
characteristic curve
Description
Shrestha B,1 Koju R,1 Makaju Shrestha S,1 Shrestha K,2 Hada G,1 Shakya YR,1 Karmacharya RM,1 Malla BR1
1Department of Surgery
2Research and Development Division
Dhulikhel Hospital, Kathmandu University Hospital
Kathmandu University School of Medical Sciences
Dhulikhel, Kavre, Nepal
Keywords
Appendectomy, Appendicitis, Lymphocyte count, Neutrophils, Receiver operating characteristic curve