Key result
Elevated preoperative leukocyte and neutrophil counts yield high diagnostic accuracy for acute appendicitis.
Why the study?
Negative appendectomies cause unnecessary admissions, healthcare burden, and cost, motivating assessment of leukocyte and neutrophil counts as preventive tools.
Do total leukocyte and neutrophil counts accurately predict appendicitis and reduce negative appendectomies in patients undergoing appendectomy?
Observational (n=408)
No
Do total leukocyte and neutrophil counts accurately predict appendicitis and reduce negative appendectomies in patients undergoing appendectomy?
Answers are grounded in this paper and cite their sources.
Normal total leukocyte and neutrophil counts are strongly associated with negative appendectomies, suggesting their utility in preventing unnecessary surgeries.
BACKGROUND: Negative appendectomies result in unnecessary admissions, health care burden, and cost. This study was conducted to assess total leukocyte and neutrophil counts as preventive tools in reducing negative appendectomies. METHODS: Data of admitted patients who underwent appendectomies was analyzed. Receiver operator characteristic (ROC) curve analysis of total leukocyte and neutrophil counts was calculated for various cut-off points. Optimum sensitivity, specificity, overall accuracy, and area under the curve was determined. RESULTS: Of the four hundred and eightpatients, true and negative appendicitis by operative assessment was 294 (72.1%) and 114 (27.9%) compared to 311 (76.2%) and 97 (23.8%) by histopathology, respectively. Optimal cut-off for total leukocyte count was >11.9x10(9)/Liter with 87.14% sensitivity and 91.75% specificity. Optimal cut-off point for neutrophil count was >7.735x10(9)/Liter with 98.71% sensitivity and 91.75% specificity. Area under the curve for total leukocyte and neutrophil counts was 0.9603 and 0.9872, respectively with overall accuracy of 91.2% and 97.1%, respectively. CONCLUSION: Normal total leukocyte and neutrophil counts are strongly associated with negative appendectomies. Non-operative measures and careful observation of total leukocyte and neutrophil counts are of paramount importance.
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Muhammad Salman Rafiq (2015) conducted an observational in Suspected acute appendicitis (n=408). Total leukocyte and neutrophil counts vs. Histopathological diagnosis (true vs negative appendicitis) was evaluated on Diagnostic accuracy (Area Under the Curve) for acute appendicitis (AUC 0.96 for TLC and 0.99 for NC, p=<0.0001). Preoperative total leukocyte count >11.9x10^9/L and neutrophil count >7.735x10^9/L yielded high diagnostic accuracy for acute appendicitis, with area under the curve values of 0.96 and 0.99, respectively.
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