Prospective validation of neutrophil-to-lymphocyte ratio as a diagnostic and management adjunct in acute appendicitis

Khan, Abidullah; Riaz, M; Kelly, Michael E.; Khan, Waqar; Waldron, Ronan; Barry, Kevin; Khan, Iqbal

doi:10.1007/s11845-017-1667-z

Cited by 22 publications

(19 citation statements)

References 29 publications

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“…showed NLCR of >6.36 associated with complicated acute appendicitis. 28 In this present study, NLCR of 5.60 was associated with gangrenous appendicitis suggesting that positive and strong correlation between high NLCR ratio have a high likelihood of perforation.…”

Section: Discussionsupporting

confidence: 57%

Comparison of the use of neutrophil: lymphocyte count ratio (NLCR) to total leukocyte count in diagnosing appendicitis in adults with right iliac fossa pain

Rabindra¹,

Bhattarai

Joshi

et al. 2018

J. Soc. Surg. Nepal

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Introduction: Diagnosis of acute appendicitis (AA) is purely based on history, examination and few laboratory investigations. However, it is often a perplexing diagnostic problem during the early stages of the disease.Failure to make an early diagnosis is a primary reason for morbidity and mortality. Elevated leukocyte count is one of the indicators of appendiceal inflammation in patients with right iliac fossa pain and most of the patients with acute appendicitis present with leucocytosis.Recently, it has been seen that the neutrophil: lymphocyte count ratio (NLCR) is a more sensitive marker than leukocytosis in patients with acute appendicitis.Method: This is a prospective observational study conducted over a period of one year in the department of surgery at the Tribhuvan University Teaching Hospital, from September 2013 to August 2014. The clinical diagnosis of Acute appendicitis was made by history and clinical examinations and laboratory investigations. Total leukocyte count (TLC) and NLCR of patients diagnosed as AA were measured and recorded in the pro forma. Histological diagnosis was taken as the final diagnosis.Results: A total of 106 patients were included in the study. Two third of the patients were male. Right iliac fossa tenderness was the most common sign. Ultrasound was able to diagnose acute appendicitis in 40.65% of the cases. NLCR> 3.5 was observed in 90.56% of patients with acute appendicitis, whereas 78.3% of patients had leukocytosis only. High NLCR (5.60) is associated with complicated AA.Conclusion: NLCR is a more sensitive laboratory parameter than TLC in patients with RIF pain to diagnose acute appendicitis. A high NLCR ratio has a high likelihood of a complicated AA.

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Section: Discussionsupporting

confidence: 57%

Comparison of the use of neutrophil: lymphocyte count ratio (NLCR) to total leukocyte count in diagnosing appendicitis in adults with right iliac fossa pain

Rabindra¹,

Bhattarai

Joshi

et al. 2018

J. Soc. Surg. Nepal

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“…Searches of electronic databases identified 287 articles of which 17 studies, 18e34 enrolling a total of 8,914 patients, were selected for this review. These included two prospective 18,19 and fifteen retrospective 20e34 observational studies. Eleven studies 18,19, 24e28 , 30e32 , 34 were included in the comparison of appendicitis versus no appendicitis; 5990 patients were included in the acute appendicitis group and 1224 patients were included in the no appendicitis group.…”

Section: Results Of the Searchmentioning

confidence: 99%

“…These included two prospective 18,19 and fifteen retrospective 20e34 observational studies. Eleven studies 18,19, 24e28 , 30e32 , 34 were included in the comparison of appendicitis versus no appendicitis; 5990 patients were included in the acute appendicitis group and 1224 patients were included in the no appendicitis group. Thirteen studies18e23 , 26e30 ,32,33 were included in the comparison of uncomplicated versus complicated appendicitis; 5844 patients had uncomplicated appendicitis and 1533 patients had complicated appendicitis.…”

Section: Results Of the Searchmentioning

confidence: 99%

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Neutrophil-to-lymphocyte ratio predicts acute appendicitis and distinguishes between complicated and uncomplicated appendicitis: A systematic review and meta-analysis

Hajibandeh

Hobbs

et al. 2020

The American Journal of Surgery

159

106

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“…Goodman et al demonstrated neutrophil-lymphocyte ratio (NLR) as a diagnostic tool for the first time, and when this ratio was greater than 3.5, they found that it was significant in diagnosing acute appendicitis (12) . In the following years, many authors have reported that the neutrophil / lymphocyte ratio (NLR) is a marker of inflammation and found it to have a preoperative diagnostic parameter in AA (13)(14)(15) .…”

Section: Introductionmentioning

confidence: 99%

Predictive Value of Neutrophil/Lymphocyte Ratios in the Diagnosis of Acute Appendicitis

Akyüz¹,

Topal²,

Gök³

et al. 2020

BMJ

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Objective: The debate on the value of laboratory tests in the diagnosis of acute appendicitis (AA) continues. In this study, we aimed to evaluate the blood count parameters and the diagnostic value of neutrophil/lymphocyte ratio in the diagnosis of acute appendicitis. Method: 851 patients who underwent appendectomy under emergency conditions were included in the study. Patients were divided into 2 groups; Group 1 was negative appendectomy and Group 2 was acute appendicitis. In addition, they were divided into subgroups as 18-39 years, 40-59 years, and 60 years and older. Neutrophil, platelet, lymphocyte count and Neutrophil/lymphocyte ratio were compared in groups and subgroups. Results: There were 146 patients (17.1%) in Group 1 (negative appendectomy group) and 705 patients (82.9%) in Group 2 (acute appendicitis group). Male sex was dominant in Group 2 (p=0.049). Neutrophil count and neutrophil / lymphocyte ratio (NLR) were higher in Group 2 (p<0.001, p<0.001, respectively), whereas in Group 1, lymphocyte count and platelet count were higher (p=0.008, p=0.002, respectively). The cutoff value for NLR was found to be 5.29 in the ROC curve analysis.

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Prospective validation of neutrophil-to-lymphocyte ratio as a diagnostic and management adjunct in acute appendicitis

Abstract: This confirms previous reports that NLR is a simple, readily available adjunct in predicting severity of appendicitis. Additionally, it can aid delineating severe appendicitis that should proceed to surgery without substantial delay.

Cited by 22 publications

References 29 publications

Comparison of the use of neutrophil: lymphocyte count ratio (NLCR) to total leukocyte count in diagnosing appendicitis in adults with right iliac fossa pain

Comparison of the use of neutrophil: lymphocyte count ratio (NLCR) to total leukocyte count in diagnosing appendicitis in adults with right iliac fossa pain

Neutrophil-to-lymphocyte ratio predicts acute appendicitis and distinguishes between complicated and uncomplicated appendicitis: A systematic review and meta-analysis

Predictive Value of Neutrophil/Lymphocyte Ratios in the Diagnosis of Acute Appendicitis

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