Abstract:

Objective: Our aim was to investigate the value of neu­trophil/lymphocyte ratio for the diagnosis of acute appen­dicitis, and for the prediction of gangrenous/perforated appendicitis. Methods: The medical records of 162 patients having undergone appendectomies between January 2013 and September 2014 including age, gender, preoperatively as­sessed C-reactive protein (CRP), white blood cell (WBC), neutrophil (NEU), lymphocyte, and neutrophil/lymphocyte ratio (NLR) values were retrospectively evaluated, com­pared with the postoperative histopathological findings, and statistically analyzed. Results: The study group consisted of 97 (59.9%) men, and 65 (40.1%) women with a median age of 36.01 (18-90). Histopathological examinations revealed normal appendix in 21 (12.96%), and acute appendicitis in 141 (87.04%) patients. Appendiceal gangrene/perforation rate was 25.31%. Lymphocyte counts were decreased, while CRP, WBC, NEU, and NLR values were increased in acute appendicitis (p<0.05). NLR ≥4.0 was associated with 16.9 times increased possibility of acute appendicitis [p<0.01, Odds ratio (OR):16.864, 95% Confidence inter­val (CI):4.696-60.568]. In cases with NLR≥4.5, it was de­tected that the risk of appendiceal gangrene/perforation was 3.2 times higher [p<0.01, OR:3.258, 95% CI: 1.468-7.228]. Conclusions: In addition to physical examination and other diagnostic methods, NLR can be considered as a useful auxiliary tool for the diagnosis of acute appendi­citis, and for the prediction of gangrenous/perforated ap­pendicitis.

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