Key result
An elevated Neutrophil to Lymphocyte Ratio (NLR) > 5.85 significantly predicted the presence of complicated appendicitis in geriatric patients with an area under the curve of 0.81.
Why the study?
Do laboratory markers identify the severity of acute appendicitis in geriatric patients?
Observational (n=73)
No
Do laboratory markers identify the severity of acute appendicitis in geriatric patients?
Effect estimate: AUC 0.81
p-value: p=<0.001
Laboratory markers such as WBC, CRP, total bilirubin, NLR, and PLR can serve as rapid, low-cost adjunctive tools to identify complicated acute appendicitis in geriatric patients.
May support NLR as adjunct in geriatric appendicitis assessment; hypothesis-generating and requires prospective validation before practice change.
Objectives: The main aim of our study is to investigate the effectiveness of laboratory markers in geriatric patients diagnosed with acute appendicitis in the emergency department. Methods: A total of 73 cases aged over 65 who underwent appendectomy were reviewed retrospectively. Age, sex, laboratory values of leukocyte count, neutrophil and lymphocyte values, platelets, serum sodium, aspartate aminotransferase (AST), alanine aminotransferase (ALT), C-reactive protein (CRP) and serum total bilirubin levels and pathological findings were investigated. The patients were divided into two different groups according to the pathology reports of appendicitis: complicated appendicitis (gangrenous/perforated appendicitis) (Group 1) and simple (uncomplicated) appendicitis (catarrhal or phlegmonous appendicitis) (Group 2). Results: A significant difference was found between Groups 1 and 2 concerning age, WBC, CRP, neutrophil, leukocyte, total bilirubin levels and neutrophil/lymphocyte ratio (NPR), and platelet/lymphocyte ratio.(PLR) No statistically significant differences were found for platelets, Na, AST and ALT levels. Conclusions: Elderly patients with complicated appendicitis often presented with higher WBC, CRP, total bilirubin, neutrophil, NLR and PLR levels, and lower lymphocyte levels. Moreover, these parameters are adjunctive data with a lower cost, easily available, and rapid markers which can be obtained in the emergency department.
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Arıcı et al. (2023) conducted an observational in Acute appendicitis (n=73). Elevated laboratory markers (NLR, total bilirubin, CRP, WBC) vs. Lower laboratory marker levels (simple appendicitis) was evaluated on Presence of complicated appendicitis predicted by Neutrophil to Lymphocyte Ratio (NLR) > 5.85 (AUC 0.81, p=<0.001). An elevated Neutrophil to Lymphocyte Ratio (NLR) > 5.85 significantly predicted the presence of complicated appendicitis in geriatric patients with an area under the curve of 0.81.
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