Predicting Acute Appendicitis in Pregnant Patients Using the Neutrophil-to-Lymphocyte Ratio: A Meta-Analysis

Feng, Yangchong; Miao, Chongxiu; Zhao, Yahui

doi:10.1089/sur.2023.269

Cited by 2 publications

(1 citation statement)

References 21 publications

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“…In 2022, Peksöz et al suggested that white blood cell count, neutrophil percentage, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and total, direct, and indirect bilirubin levels could aid in diagnosing acute appendicitis in pregnant women and may even predict complicated forms of the disease in some cases [ 12 ]. In 2023, Feng et al conducted a meta-analysis and found that the NLR is a valuable and effective diagnostic tool for acute appendicitis during pregnancy [ 13 ]. More recently, in 2024, Adir et al demonstrated that biomarkers such as the NLR and the monocyte-to-lymphocyte ratio (MLR) can be useful for diagnosing acute appendicitis, particularly in pregnant women where the use of CT is contraindicated [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Early Diagnosis of Acute Appendicitis in the Second Trimester of Pregnancy Based on Non-typical Clinical Findings: Report of a Rare Case and a Mini-Review of the Literature

Thanasa,

Antoniou

et al. 2024

Cureus

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Acute appendicitis is the most common non-obstetric reason for exploratory laparotomy during pregnancy. This case report involves a primigravida patient who presented to the emergency department of the General Hospital of Trikala at 15 weeks of gestation due to diffuse abdominal pain, primarily in the epigastric region. She also reported watery bowel movements. The ongoing atypical clinical symptoms, along with elevated inflammatory markers, strongly indicated a diagnosis of acute appendicitis. An immediate exploratory laparotomy was performed, during which acute localized inflammation of the appendix was found, leading to an appendectomy. Histological examination confirmed the diagnosis of acute appendicitis. The patient reported pain relief immediately after the surgery. On the fourth postoperative day, she was discharged without any signs of a threatened second-trimester miscarriage. At 39 gestational weeks, she delivered by elective cesarean section due to breech presentation. This paper discusses the case and highlights the significant challenges in the early diagnosis and management of acute appendicitis during pregnancy, emphasizing the importance of preventing potentially life-threatening complications for both the mother and the fetus.

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Section: Discussionmentioning

confidence: 99%

Early Diagnosis of Acute Appendicitis in the Second Trimester of Pregnancy Based on Non-typical Clinical Findings: Report of a Rare Case and a Mini-Review of the Literature

Thanasa,

Antoniou

et al. 2024

Cureus

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The diagnostic value of systemic inflammation indices in pregnant women with acute appendicitis and their relationship with the duration of hospital stay

Uçar,

Taş

2024

Turkish Journal of Clinics and Laboratory

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Aim: Physiological and anatomical changes occurring during pregnancy can complicate the diagnosis of acute appendicitis (AA). This study aimed to evaluate the diagnostic performance of systemic inflammation indices in distinguishing AA in pregnant women and to assess their relationship with hospital stay duration. Material and Methods: This retrospective study encompassed 32 pregnant patients who underwent appendectomy and 32 healthy pregnant (control group). Systemic inflammation indices were calculated based on neutrophil (N), platelet (P), and lymphocyte (L) levels as follows: The neutrophil-to-lymphocyte ratio (NLR) = N/L; the platelet-to-lymphocyte ratio (PLR) = P/L; systemic immune-inflammation index (SII) = (N×P)/L. Results: The AA group had higher median levels of PLR (30.9 vs. 22.4, p = 0.035), NLR (6.1 vs. 3.5, p < 0.001), and SII (1370 vs. 807, p < 0.001) compared to the control group. Systemic inflammation indices showed a positive correlation with the Alvarado score and the length of hospital stay. SII values demonstrated superior diagnostic performance in predicting AA compared to NLR and PLR values. The threshold value for SII in predicting AA was identified as >1316, with a sensitivity of 85.8% and a specificity of 72.5%. Conclusions: Systemic inflammation indices, particularly SII, demonstrate strong diagnostic value in distinguishing AA in pregnant women. SII demonstrated superior accuracy over NLR and PLR, correlating with both the Alvarado score and hospital stay, suggesting its utility as a diagnostic and prognostic marker.

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Predicting Acute Appendicitis in Pregnant Patients Using the Neutrophil-to-Lymphocyte Ratio: A Meta-Analysis

Cited by 2 publications

References 21 publications

Early Diagnosis of Acute Appendicitis in the Second Trimester of Pregnancy Based on Non-typical Clinical Findings: Report of a Rare Case and a Mini-Review of the Literature

Early Diagnosis of Acute Appendicitis in the Second Trimester of Pregnancy Based on Non-typical Clinical Findings: Report of a Rare Case and a Mini-Review of the Literature

The diagnostic value of systemic inflammation indices in pregnant women with acute appendicitis and their relationship with the duration of hospital stay

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