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Aims: Acute appendicitis is a prevalent disease. In recent years, conservative treatment of acute uncomplicated appendicitis has been popular but complicated disease requires surgery. This study was conducted to search whether white blood cell (WBC) count, mean platelet volume (MPV), red blood cell distribution width (RDW), and neutrophil-to-lymphocyte ratio (NLR) might be useful to distinguish complicated and uncomplicated appendicitis. Methods: In this single-center retrospective study, we evaluated patients who underwent open appendectomy between January 2013 and December 2015. Then, the subjects were divided into two groups according to surgical exploration and pathological examination: complicated appendicitis and uncomplicated appendicitis. Complicated cases were classified into 3 subgroups: 1) appendix perforation, 2) plastron appendicitis, and 3) necrosis of appendix. WBC, MPV, RDW, and NLR values were compared in all groups. Results: A total of 1,219 patients were analyzed. Complicated appendicitis was more common in male patients (n=71, 9.6%). The median WBC (16.1x109/L) and NLR (7.9 n/µL) were significantly higher in complicated appendicitis compared to uncomplicated disease (p<0.001, for both). The cut-off value for WBC and NLR to distinguish a complicated disease was 14.6x109/L and 6.2 n/µL, respectively. MPV and RDW were not useful. Conclusions: WBC and NLR may be helpful in distinguishing between complicated and uncomplicated appendiceal disease. However, we observe no significant differences in RDW and MPV levels in patients with complicated appendicitis.

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