Mean platelet volume, red cell distribution width, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in the diagnosis acute appendicitis

Toktaş, Osman; Aslan, Mehmet

doi:10.5505/ejm.2017.85570

Cited by 9 publications

(12 citation statements)

References 18 publications

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“…This study found that acute appendicitis was more common in males than females. The results of this study were in line with research by Tanrikulu et al,Yilmas et al, and study by 3,4 Toktas and Aslan. These results were in accordance with epidemiological data of acute appendicitis which showed a higher incidence of the disease in 3,4 males than females with a ratio of 3:2.…”

Section: Resultssupporting

confidence: 93%

“…Despite the increased use of Ultrasonography (USG), Computer Tomography (CT), and diagnostic laparoscopy, the misdiagnosis of appendicitis tends to remain the same (15.3%). This imaging modality is not enough to help prompt 3,4 and precise diagnosis of acute appendicitis. The diagnosis of acute appendicitis is based on clinical symptoms and laboratory test results.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of Hematologic Parameters and Serum Bilirubin Levels in Complicated and Uncomplicated Acute Appendicitis Patients

Rahman¹,

Kartini²,

Widaningsih³

et al. 2020

Indonesian J. Clin. Pathol. Med. Lab.

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Acute appendicitis is inflammation of the vermiformis appendix due to lumen obstruction followed by bacterial infection. Acute appendicitis is classified into two types of disease, namely complicated and uncomplicated. Acute inflammation of the appendix requires immediate surgical action to prevent complications; therefore, a further laboratory test is required. This study was retrospective research which analyzed several hematologic parameters (WBC, Neutrophils, NLR, RDW, PLTMPV, PDW) and serum bilirubin levels. Data were statistically analyzed using Independent-t and Mann-Whitney test. Univariate logistic regression test was used to evaluate the correlation of hematologic parameters and significant serum bilirubin levels with the diagnosis of complicated and uncomplicated appendicitis. The cut-off value and diagnosis value were measured using Receiver Operating Characteristic (ROC) curve analysis. This study involved 173 subjects categorized into 67 complicated and 106 uncomplicated acute appendicitis patients. Whole blood count and neutrophil counts were significantly higher in complicated acute appendicitis (p <0.05). Similarly, NLR and PLT were significantly higher in complicated acute appendicitis (p <0.001), p > 0.05 was obtained in RDW-CV, MPV and PDW values. The higher serum bilirubin levels were reported in patients with complicated acute appendicitis compared to uncomplicated acute appendicitis (p <0.001). Logistic regression test results showed significant PLT parameters with p <0.001, while there was no significance of hematologic parameters such as WBC, neutrophil, NLR, RDW-CV, MPV, PDW and bilirubin levels. Area under curve results on the ROC curve showed 74.4% PLT with sensitivity and specificity of 97.17% and 40.29%, respectively. From the analysis of hematologic parameters and measurement of serum bilirubin levels, only the PLT parameter can be used as one of the parameters for the diagnosis of complicated appendicitis with high sensitivity but low specificity. It was recommended to perform prospective studies with more subjects.

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Section: Resultssupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Analysis of Hematologic Parameters and Serum Bilirubin Levels in Complicated and Uncomplicated Acute Appendicitis Patients

Rahman¹,

Kartini²,

Widaningsih³

et al. 2020

Indonesian J. Clin. Pathol. Med. Lab.

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“…A comprehensive literature search of all observational studies assessing this relationship was performed. The findings indicate that the PLR level is significantly higher in AA individuals compared to the non-AA ones which is in line with previous reports [40,42,43]. Moreover, though the results of most subgroups are consistent with the main analysis, findings did not suggest that the PLR levels was significantly correlated with perforated AA, probably because of low statistical power with few included studies.…”

Section: Principal Findingssupporting

confidence: 87%

“…Twenty-four articles were retrieved and reviewed based on full text. Finally, 11 articles met the inclusion criteria and were included in our meta-analysis [26][27][28][39][40][41][42][43][44][45][46].…”

Section: Literature Searchmentioning

confidence: 99%

Is the platelet to lymphocyte ratio a promising biomarker to distinguish acute appendicitis? Evidence from a systematic review with meta-analysis

Liu

Shao

et al. 2020

PLoS ONE

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Background Although several previous studies have examined the association between the platelet to lymphocyte ratio (PLR) and acute appendicitis (AA), findings have been controversial. We aimed to systematically assess the available evidence to elucidate the overall relationship between the PLR and AA. Methods Pubmed and Embase databases were searched for all available published literature before August, 2019 by two independent investigators for observational studies reporting the association between the PLR and AA. Random effects models were applied for all meta-analyses. Pooled standardized mean difference (SMD) and 95% confidence interval (CI) were calculated as effect estimates. Results Eleven articles met the inclusion criteria and included in this study. Meta-analysis showed that the level of PLR in the AA group was significantly higher than that in the control group (SMD: 1.19, 95% CI: 0.75 to 1.62, P<0.001). A series of subgroup analyses were conducted to investigate the heterogeneity, showing a significant increase in PLV levels in adults with age �30 years (SMD: 1.46, 95% CI: 0.89 to 2.02),compared to those in adult <30 years (SMD: 0.58, 95% CI: 0.12 to 1.04) or in children (SMD: 1.03, 95% CI: 0.51 to 1.56). Compared to non-AA controls, a significant increased PLR level was also observed in non-perforated AA (SMD: 1.23, 95% CI: 0.88 to 1.59) and in AA patients during pregnancy (SMD: 0.70, 95% CI: 0.36 to 1.04), while not in perforated AA (SMD: 2.28, 95% CI:-1.72 to 6.28).

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“…This result is consistent with the findings of previous studies (12, 24, 25). Although TWBC showed a significant association with appendicitis, NLR proved superior and has greater diagnostic accuracy compared to TWBC alone (16, 26, 27). In addition, NLR might be more sensitive than the TWBC for the diagnosis of appendicitis, as neutrophils are increased and lymphocytes are decreased by infectious diseases such as appendicitis (28).…”

Section: Discussionmentioning

confidence: 92%

A Cross-Sectional Study of Neutrophil-to-Lymphocyte Ratio in Diagnosing Acute Appendicitis in Hospital Melaka

Ahmad

Ideris

Aziz

2019

MJMS

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BackgroundAcute appendicitis is one of the most common surgical emergencies. However, its proper diagnosis is complicated. This study aims to evaluate the ability of the neutrophil-to-lymphocyte ratio (NLR) to diagnose acute appendicitis in pre-operative state.MethodsHistopathological examination of appendicectomies conducted between 2016 and 2017 in Melaka Hospital, Malaysia were traced and categorised into three groups: i) G1 (normal appendix), ii) G2 (acute appendicitis) and iii) G3 (perforated appendicitis). The reports were randomised and a total of 338 samples were collected. NLR values were compared between the three different groups and analysed.ResultsThe median values of NLR for G1, G2 and G3 were 2.37, 5.25 and 9.27, respectively. We found a statistically significant difference in NLR between G1 and G2 (P < 0.001), and G2 and G3 (P < 0.001). The diagnostic values of NLR for acute appendicitis and perforated appendicitis were 3.11 (sensitivity: 75.23%, specificity: 68.70%) and 6.17 (sensitivity: 76.32%, specificity: 58.72%), respectively. There was a substantial correlation between NLR and disease severity, and a moderate correlation between NLR and duration of admission.ConclusionNLR, with a sensitivity of 75.23% and specificity of 68.70%, is a useful and reliable adjunct in diagnosing acute appendicitis. Hence, it will help in reducing the rate of negative appendicectomies.

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Mean platelet volume, red cell distribution width, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in the diagnosis acute appendicitis

Cited by 9 publications

References 18 publications

Analysis of Hematologic Parameters and Serum Bilirubin Levels in Complicated and Uncomplicated Acute Appendicitis Patients

Analysis of Hematologic Parameters and Serum Bilirubin Levels in Complicated and Uncomplicated Acute Appendicitis Patients

Is the platelet to lymphocyte ratio a promising biomarker to distinguish acute appendicitis? Evidence from a systematic review with meta-analysis

A Cross-Sectional Study of Neutrophil-to-Lymphocyte Ratio in Diagnosing Acute Appendicitis in Hospital Melaka

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