eP81 Platelet indices and red cell distribution width in the diagnosis of acute appendicitis

Aims To determine the role of platelet indices and red cell distribution width (RDW) in the diagnosis of acute appendicitis. Methods In this prospective study, patients of age >18 years with a diagnosis of acute appendicitis were included and grouped into four categories - histopathologically normal appendix, uncomplicated appendicitis, complicated appendicitis and conservatively managed group. Haematological parameters such as total leucocyte count (TLC), differential leucocyte count (DLC-N), absolute neutrophil count (ANC), mean platelet volume (MPV), platelet distribution width (PDW), and RDW were correlated between the groups. Results In a total of 237 patients, the haematological parameters, TLC, DLC-N, and ANC were significantly higher in positive appendicectomy group. However, MPV, PDW and RDW were comparable. Univariate analysis revealed male gender (p=0.004), TLC (p=0.001); DLC-N (p=0.001); DLC-L (p=0.001); ANC (p=0.001) were associated with acute appendicitis. Multivariate logistic regression analysis was carried out for parameters which were significant in univariate analysis, but none were found to be independently associated with acute appendicitis expect for gender (p=0.01). The overall accuracy by receiver operating characteristic (ROC) curve showed that area under the curve (AUC) was good for ANC (0.73; CI: 0.62-0.83), TLC (0.71; CI: 0.61-0.81) and for DLC-N (0.70; CI: 0.58-0.83). The cut-off values for ANC, TLC and DLC-N were 6.44x103/uL, 10.47x103/uL and 61.5% respectively. Conclusion The study showed that MPV, PDW and RDW were not indicative of acute appendicitis. However, elevated leucocyte parameters such as TLC, DLC-N, DLC-L, and ANC in combination is associated with the diagnosis of acute appendicitis.