Predictive role of the neutrophil to lymphocyte ratio and platelet to lymphocyte ratio for diagnosis of acute appendicitis during pregnancy

Amaç

Acute appendicits (AA), a leading pathology requiring surgery in the pregnancy period is an inflammatory condition with difficulties in diagnosis. There are studies in the literature reporting that Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are early markers of local or systemic inflammation. Objective of this study was to evaluate predictive affects of NLR and PLR in addition to the conventional diagnostic methods in acut appendicitis.

Yöntem

In this study; age, gestational age, lymphocyte number, Alvarado scores (AS), levels of C-reactive protein, NLR and PLR values were studied in 28 patients operated due to AA (Appendectomy Group), 35 patients hodpitalized with the suspection of AA and considered not to have appendicitis in the follow-up (Expectant Group), 29 healthy pregnants (Healty Pregnant Control Group) and 30 non-pregnant healthy patients (Healty Women Control group).

Bulgular

Mean WBC count and CRP level were higher in the Appendectomy than in the control group (p<0.05 and p<0.05; respectively). Similarly median NLR and PLR levels were found to be statistically significantly different in the appendectomy group compared to all of the other groups (p<0.05 and p<0.05; respectively). Cut-off values were calculated with ROC analysis for WBC count (13880, p=0.030), CRP (10.1, p<0.001), lymphocyte count (1.54, p<0.001), NLR (6.84, p<0.001) and PLR (121.78, p<0.001). When WBC count, CRP, lymphocyte count, NLR and PLR were assessed with Multiple Logistic Regression analysis, it was found that accurate diagnosis of AA could be established with the combined use of these variable parameters with 90.5% accuracy.

Sonuç

In addition to the routine diagnostic methods, NLR and PLR could increase the accuracy in diagnosis of appendicitis in pregnants. 

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