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. 2019 Oct 17:48:35-38.
doi: 10.1016/j.amsu.2019.10.013. eCollection 2019 Dec.

Accuracy of neutrophil lymphocyte ratio for diagnosis of acute appendicitis in children: A diagnostic study

Dedi Prasetya  1   2 , Rochadi  1 , Gunadi  1
Affiliations

Accuracy of neutrophil lymphocyte ratio for diagnosis of acute appendicitis in children: A diagnostic study

Dedi Prasetya et al. Ann Med Surg (Lond). .

Abstract

Background: Many biomarkers for diagnosis of acute appendicitis in children have been reported, however, the results are still controversial. We assessed the accuracy of neutrophil-lymphocyte ratio (NLR) for diagnosis of acute appendicitis and discriminating simple and complicated appendicitis in children.

Methods: We included 121 patients with acute appendicitis and 49 children with intussusception as controls who were admitted at our hospital from 2013 to 2017. White blood count (WBC), neutrophil, and NLR were compared between groups.

Results: Neutrophil and NLR were significantly higher in the acute appendicitis group than control (76.17 ± 14.41 vs. 62.43 ± 15.9%, p=<0.0001; and 8.44 ± 6.63 vs. 3.38 ± 2.84, p=<0.0001, respectively), while WBC, neutrophil, and NLR were significantly greater in complicated than simple appendicitis (15.86 ± 6.48 vs. 12.64 ± 6.27 × 103/μL, p = 0,008; 82.64 ± 8.41 vs. 68.99 ± 16.23%, p=<0.0001; and 11.32 ± 6.87 vs. 5.25 ± 4.65, p=<0.0001, respectively). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), area under the receiver operating characteristic (ROC) curve, and cutoff point of NLR for diagnosis of acute appendicitis were 83.5%, 57.7%, 81.4%, 61.2%, 0.764, and 2.87, respectively; whereas the sensitivity, specificity, PPV, NPV, area under the ROC curve, and cutoff point of NLR for differentiating complicated and simple appendicitis were 84.6%, 56.5%, 35.5%, 92.9%, 0.790, and 6.59, respectively.

Conclusion: NLR shows a high accuracy for diagnosis of acute appendicitis and distinguishing a complicated appendicitis from the simple one.

Keywords: Accuracy; Acute appendicitis; Children; Diagnosis; Neutrophil lymphocyte ratio.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
A) ROC curve of neutrophil and NLR for diagnosis of acute appendicitis, with the AUC of 0.756 and 0.764, respectively; B) ROC curve of WBC, neutrophil, and NLR for distinguishing between simple and complicated appendicitis, with the AUC of 0.644, 0.762, and 0.79, respectively.
See this image and copyright information in PMC

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