Title: Role of Neutrophil-to-lymphocyte ratio as a predictor of acute appendicitis
Authors: Dr Paul Dhinakaran, Dr Sreeramulu P N, Dr Srinivasan D
Introduction: Acute appendicitis (AA) is the most common surgical abdominal emergency. Diagnosis still remains purely clinical and which is still associated with low specificity, with negative findings intra-operatively. This study is undertaken to find out a biochemical investigation to aid in the diagnosis of Acute Appendicitis.
Materials and Methods: We retrospectively reviewed 70 patients recorded over the period encompassing three years (2015-2017) at RL Jalappa hospital and research centre, Tamaka, Kolar with AAhad a pathology report that confirmed the diagnosis of acute appendicitis.
The patients were divided into three groups with group 1 consisting of uncomplicated appendicitis group 2 with complicated appendicitis (perforation and gangrenous), group 3 control group with other causes of abdominal pain for evaluation.
Results: There were 30 patients in group 1, 20 patients in group 2 and 20 patients in the control group (group 3). There were no significant differences between groups in terms of age or gender. Significant differences emerged in leukocyte and NLR. There was a significant difference between group 1 and group 2 in terms of radiological appendix diameter and contamination around the appendix and fluid accumulation (p=0.001). However, a significant difference was not detected between NLR increase and contamination around the appendix, fluid accumulation, or appendix diameter.
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.