Predicting the severity of acute appendicitis in children using neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR)
Ayeni, Adewale Mahmood, Fahad Mustafa, Ameer Mcleish, Bethan Kulkarni, Vaibhavi Singhal, Shika Akingboye, Akinfemi
Ayeni, Adewale
Mahmood, Fahad
Mustafa, Ameer
Mcleish, Bethan
Kulkarni, Vaibhavi
Singhal, Shika
Akingboye, Akinfemi
Abstract
Introduction The ability to predict risk of perforation in acute appendicitis (AA) could direct timely management and reduce morbidity. Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are surrogate severity markers in infections. This study investigates the use of PLR and NLR as a marker for distinguishing uncomplicated (UA) and complicated appendicitis (CA) in children. Materials and methods This retrospective single-center study collected data between January 1, 2014, and December 31, 2020. Children between five and 17 years of age with histologically confirmed appendicitis were included. Cut-off values for NLR and PLR were determined by employing the receiver operating characteristic (ROC) curve with sensitivity and specificity in addition to regression analysis. Results A total of 701 patients were included with a median age of 13 years. Out of which 52% of the cohort was female. The difference between the NLR and PLR ratios between UA and CA was significant (p=0.05, Kruskal-Wallis). For UA, the area under the ROC curve (AUC) and cut-off for NLR and PLR were 0.741, 3.80 with 95% CI of 0.701-0.781 and 0.660, 149.25 with 95% CI of 0.618-0.703, respectively. In CA, using NLR and PLR, AUC and cut-off were 0.776, 8.86 with 95%CI of 0.730-0.822 and 0.694, 193.67 with 95%CI of 0.634-0.755, respectively. All were significant with p<0.001. Conclusions NLR and PLR are reliable, synergistic markers predicting complicated appendicitis which can guide non-operative management in children.
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Date
2022-08-31
Type
Article
Subject
Surgery, Paediatrics
Collections
Citation
Ayeni A, Mahmood F, Mustafa A, Mcleish B, Kulkarni V, Singhal S, Akingboye A. Predicting the Severity of Acute Appendicitis in Children Using Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR). Cureus. 2022 Aug 31;14(8):e28619.
Journal / Source Title
Cureus
DOI
10.7759/cureus.28619
PMID
36185898
Publisher
Springer