Platelet indices and neutrophil to lymphocyte ratio in adults with acute appendicitis

Abstract

Background: A study was performed in adults with acute appendicitis and matched controls to assess the utility of the platelet indices and neutrophil to lymphocyte ratio, as a diagnostic adjunct
Methods: Data were retrospectively collected from a complete blood count test of 155 adult patients (72 men and 83 women) with histologically proven acute appendicitis upon admission, and of 50 healthy adults (20 men and 30 women). The parameters for white blood cells and platelets were compared between the two groups, and for each gender separately.
Results: A higher white blood cell count, neutrophil count, neutrophil percentage, neutrophil to  lymphocyte ratio and lower lymphocyte percentage was reported in patients with acute appendicitis  than that in the healthy controls, with high areas under the curve (AUC), sensitivities, specificities,  positive predictive values (PPVs) and moderate negative predictive values (NPVs). The lymphocyte  count was lower in patients than it was in the healthy controls. The platletcrit was lower in the female patients than that in the female controls, whereas a difference was not detected in the male  participants. Differences were not detected with regard to platelet count, mean platelet volume and platelet distribution width for both genders.
Conclusion: The neutrophil to lymphocyte ratio increases and lymphocyte percentage decreases in acute appendicitis, and can be used as an additional diagnostic marker. Plateletcrit, and therefore total platelet mass, is reduced in women with acute appendicitis, indicating the involvement of platelets in its pathophysiology. However, it is neither a reliable predictor or excluder of the disease.