Key result
Preoperative NLR yields AUC 0.86 for diagnosing elderly acute appendicitis and rises with disease severity.
Why the study?
Computed tomography has lower diagnostic accuracy for acute appendicitis in elderly patients compared to the normal population, and radiation exposure concerns exist.
Can RDW and NLR be used as adjuvant parameters to support CT in predicting the diagnosis and severity of acute appendicitis in elderly patients?
Observational (n=120)
Yes
Can RDW and NLR be used as adjuvant parameters to support CT in predicting the diagnosis and severity of acute appendicitis in elderly patients?
The study aims to evaluate if RDW and NLR can serve as reliable preoperative predictors for acute appendicitis in elderly patients to potentially reduce reliance on CT.
Answers are grounded in this paper and cite their sources.
NLR may support preoperative assessment in elderly appendicitis; hypothesis-generating and requires prospective validation before changing CT pathways.
Backgroundː Acute appendicitis (AA) is one of the most common emergency surgical pathologies in the elderly population. Although, the use of Computed Tomography (CT) is strongly recommended to reduce negative appendectomy rates in the elderly patients diagnostic accuracy rates of CT are, nevertheless, lower than normal population and therefore(??) radiation exposure should be taken into consideration in some patient groups. In the present study, we have analyzed the relationship of RDW (Red Cell Distribution Width) and NLR (Neutrophil/Lymphocyte Ratio) used as inflammatory parameters with appendix diameter in the elderly patients and assessed its preoperative predictive reliability in the elderly patients.
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Mustafa Atabey (2021) conducted an observational in Acute appendicitis (n=120). Neutrophil/Lymphocyte Ratio (NLR) and Red Cell Distribution Width (RDW) vs. Negative pathology (normal appendix) was evaluated on Diagnostic accuracy (AUC) of Neutrophil/Lymphocyte Ratio (NLR) for detecting acute appendicitis (AUC 0.86, 95% CI 0.79-0.93, p=<0.001). Preoperative Neutrophil/Lymphocyte Ratio (NLR) demonstrated strong diagnostic accuracy for acute appendicitis in elderly patients (AUC 0.86) and significantly increased with disease severity.
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