Akademik Veri Yönetim Sistemi
Bakırköy Tıp Dergisi, cilt.16, sa.1, ss.76-84, 2020 (ESCI)
Objective: The debate on the value of laboratory tests in the diagnosis of acute appendicitis (AA) continues. In this study, we aimed toevaluate 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 2groups; Group 1 was negative appendectomy and Group 2 was acute appendicitis. In addition, they were divided into subgroups as 18-39years, 40-59 years, and 60 years and older. Neutrophil, platelet, lymphocyte count and Neutrophil/lymphocyte ratio were compared in groupsand subgroups.Results: There were 146 patients (17.1%) in Group 1 (negative appendectomy group) and 705 patients (82.9%) in Group 2 (acute appendicitisgroup). 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). Thecutoff value for NLR was found to be 5.29 in the ROC curve analysis. In this value, NLR sensitivity was found as 57.3%, specificity as 69.9%,positive predictive value as 57,1%, negative predictive value as 69,2%. Multivariate analysis showed that the risk of acute appendicitis was6.71 times higher in patients with NLR I5.29 (OR: 6.71+0.28; 95% CI: 6,150-7,276; p=0.024). In subgroups, the cut-off point for NLR was 5.10for 18-39 years; 6.63 for 40-59 years; and 5.80 for 60 years and older. The highest sensitivity for these cut-off points was in the age group of60 and over with 69%, while the highest specificity was in the 40-59 years age group with 58.2%.Conclusion: Although the sensitivity and specificity of neutrophil /lymphocyte ratio (NLR) varies according to age groups, it is a useful andhelpful parameter for physical examination and other diagnostic methods in the diagnosis of acute appendicitis.