Accuracy of Neutrophil to Lymphocyte Ratio in Predicting for Rupture Appendicitis Patient in Uttaradit Hospital

Authors

  • Nichanart Lormuangthong Medical Education Center Uttaradit Hospital
  • Phakkaphol Khumpasung
  • Nawinda Musikpodok

DOI:

https://doi.org/10.1016/hscr.v37i1.256104

Keywords:

Ruptured appendicitis

Abstract

Introduction : Ruptured appendicitis is the most serious complications of acute appendicitis. The incidence is 2.9 per 10,000 persons. Because of the delayed diagnosis, there are more postoperative complications. When inflammatory biomarkers were investigated to predict ruptured appendicitis, the neutrophil to lymphocyte ratio (NLR) was found to be the most responsive. However, there are limitations in the selection of population that have a significant effect on the NLR, such as age and underlying disease. As a result, a study of patients 15-60 years without underlying disease was conducted.

Objective : To investigate the accuracy of NLR in predict ruptured appendicitis and to determine the cutoff value of NLR in predict ruptured appendicitis in Uttaradit hospital patients.

Method : From November 3rd 2019 to November 3rd 2021, 328 appendectomy patients aged 15-60 years were studied at Uttaradit hospital. There were 273 patients with appendicitis without complications and 55 patients with ruptured appendicitis included. Data was collected from ICD-10 medical records (K35), which were separated into two groups. All data were analyzed by descriptive and analytic statistics.

Conclusion: The NLR cutoff value of 7.1 can significantly predict appendicitis rupture. Other factors should be considered to improve accuracy. The NLR can be used as a guideline for making decisions about referring patients to appropriate medical centers, treatment, informing patients and families.

References

Koyuncu S. The Role of C-Reactive Protein to Lymphocyte Ratio in the Differentiation of Acute and Perforated Appendicitis. Turk J Trauma Emerg Surg [Internet]. 2020 [cited 2021 Nov 8]; Available from:http://www.tjtes.org/eng/jvi.aspxpdir=travma&plng=eng&un=UTD-47973.

Jung SK, Rhee DY, Lee WJ, Woo SH, Seol SH, Kim DH, et al. Neutrophil-to-lymphocyte count ratio is associated with perforated appendicitis in elderly patients of emergency department. Aging Clin Exp Res. 2017 Jun;29(3):529–36.

Ozkan A, Gokce AH, Gokce FS. The importance of laboratory tests and Body Mass Index in the diagnosis of acute appendicitis. POL PRZEGL CHIR.:5.

Sirikurnpiboon S, Amornpornchareon S. Factors Associated with Perforated Appendicitis in Elderly Patients in a Tertiary Care Hospital.

Surg Res Pract. 2015;2015:1–6.

Khairol AA, Noorharisman I, Syed HSAA. A Cross-Sectional Study of Neutrophil-to-Lymphocyte Ratio in Diagnosing Acute Appendicitis in Hospital Melaka. Malays J Med Sci. 2019 Nov; 26(6):55–66.

Iamarino APM, Juliano Y, Rosa OM, Novo NF, Favaro MDL, Ribeiro Júnior MAF. Risk factors associated with complications of acute appendicitis. Rev Colégio Bras Cir. 2017 Dec;44(6):560–6.

Akai M, Iwakawa K, Yasui Y, Yoshida Y, Kato T, Kitada K, et al. Hyperbilirubinemia as a predictor of severity of acute appendicitis. J Int Med Res. 2019 Aug;47(8):3663–9.

Brunicardi FC, editor. Schwartz’s principles of surgery. Eleventh edition. New York: McGraw-Hill; 2018.

Senavat P, Jearwatanakanok K. Clinical prediction scores for ruptured appendicitis in acute appendicitis

patients. J Nakornping Hosp [Internet]. 2020 [cited 2021 Nov 8];10(2). Available from: https://he01.tci-thaijo.org/index.php/jnkp/article/view/240633.

Kim MJ, Choi WH, Cheong JC, Choi SY, Kim JW, Park JH. Delta neutrophil index and symptomatic time are effective factors for predicting perforated appendicitis. Medicine (Baltimore). 2021 May 21;100(20):e25935.

Hajibandeh S, Hajibandeh S, Hobbs N, Mansour M. Neutrophil-to-lymphocyte ratio predicts acute appendicitis and distinguishes between complicated and uncomplicated appendicitis: A systematic review and meta-analysis. Am J Surg. 2020 Jan;219(1):154–63.

Ahmed S, Jha A, Ali FM, Ghareeb AE, Garg D, Jha M. Sensitivity and Specificity of the Neutrophil-lymphocyte Ratio in the Diagnosis of Acute Appendicitis. 2019;49(5):7.

Akbas A. The value of inflammatory markers in diagnosing acute appendicitis in pregnant patients. Turk J Trauma Emerg Surg [Internet]. 2020 [cited 2021 Nov 8];Available from: http://www.tjtes.org/eng/ jvi. aspx?pdir=travma&plng=eng&un=UTD-03456.

Virmani S, Prabhu P, Sundeep P, Kumar V. Role of laboratory markers in predicting severity of acute appendicitis. Afr J Paediatr Surg. 2018;15(1):1.

Khan A, Riaz M, Kelly ME, Khan W, Waldron R, Barry K, et al. Prospective validation of neutrophilto-lymphocyte ratio as a diagnostic and management adjunct in acute appendicitis. Ir J Med Sci 1971 -2018 May;187(2):379–84.

Kilicaslan B. The relationship between neutrophil to lymphocyte ratio and blood pressure variability in hypertensive and normotensive subjecs. Turk Kardiyol Dernegi Arsivi-Arch Turk Soc Cardiol. 2015;43(1):18–24.

Sefil F, Ulutas KT, Dokuyucu R, Sumbul AT, Yengil E, Yagiz AE, et al. Investigation of neutrophil lymphocyte ratio and blood glucose regulation in patients with type 2 diabetes mellitus. J Int Med Res. 2014 Apr;42(2):581–8.

Begic-Kapetanovic S, Avdagic N, Zaciragic A, Hasic S, Babic N, Hadzimuratovic A. Could the neutrophil-to-lymphocyte ratio serve as a marker in the diagnosis and prediction of acute appendicitis complications in children? Arch Med Sci [Internet]. 2019 Sep 9 [cited

Nov 19]; Available from: https://www.archivesof medicalscience.com/Could-the-neutrophil-to-lymphocyte-ratio-serve-as-a-marker-in-the-diagnosis-and-prediction,99612,0,2.html

Balogun O, Osinowo A, Afolayan M, Olajide T, Lawal A, Adesanya A. Acute perforated appendicitis in adults: Management and complications in Lagos, Nigeria. Ann Afr Med. 2019;18(1):36.

Eddama M, Fragkos K, Renshaw S, Aldridge M, Bough G, Bonthala L, et al. Logistic regression model to predict acute uncomplicated and complicated appendicitis. Ann R Coll Surg Engl. 2019 Feb;101(2):107–18.

Yazar FM, Urfalioglu A, Bakacak M, Boran ÖF, Bülbüloğlu E. Efficacy of the Evaluation of Inflammatory Markers for the Reduction of Negative Appendectomy Rates. Indian J Surg. 2018 Feb;80(1):61–7.

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Published

2022-06-30

How to Cite

1.
Lormuangthong N, Khumpasung P, Musikpodok N. Accuracy of Neutrophil to Lymphocyte Ratio in Predicting for Rupture Appendicitis Patient in Uttaradit Hospital. HSCR [Internet]. 2022 Jun. 30 [cited 2024 Apr. 23];37(1):33-4. Available from: https://he02.tci-thaijo.org/index.php/hscr/article/view/256104

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Original Articles (นิพนธ์ต้นฉบับ)
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