Predictive value of the Neutrophil/Lymphocyte Ratio in the diagnosis of complicated acute appendicitis in pediatric patients

Abstract

Acute appendicitis in children requires an accurate and timely diagnosis to reduce morbidity and mortality. Different biomarkers have been studied, including the neutrophil/lymphocyte ratio (NLN), which have shown diagnostic value
and a predictor of severity. Objective: To evaluate the predictive capacity of the  Neutrophil/Lymphocyte Ratio to differentiate between complicated and uncomplicated acute appendicitis. Materials and Methods: 90 pediatric
patients who suffered from pathology-confirmed acute appendicitis between 2019 and 2020 were studied. The RNL was compared between 2 groups. ROC analysis was used to find the area under the curve and the optimal cutoff
point to differentiate complicated from uncomplicated appendicitis. Results: RNL was significantly higher in the group with complications than in the group without complications (11.25 +/- 6.70 vs 8.37 +/- 6.13 p = 0.025). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), area under the ROC curve, and RNL cut-off point to differentiate complicated from  uncomplicated acute appendicitis were 55.81%, 63.83%, 58.54%, 61.22%, 0.6368 (95% CI 0.5223 - 0.7513) and 9,591, respectively. Conclusion: The Neutrophil/Lymphocyte Ratio has a moderate ability to distinguish between complicated and uncomplicated acute appendicitis.