scholarly journals 1575 Predictive Ability of Neutrophil-To-Lymphocyte Ratio in Acute Appendicitis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
G Nawaz ◽  
M Qayum ◽  
S Hajibandeh ◽  
S Hajibandeh
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Predictive Ability ◽  
Clinical History ◽  
Complicated Appendicitis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
History Of ◽  
And Gender ◽  
Sensitivity Specificity

Abstract Aim Neutrophil-to-lymphocyte ratio (NLR) predicts both diagnosis and severity of appendicitis. We aimed to evaluate accuracy of NLR to predict acute appendicitis and whether it can distinguish between uncomplicated and complicated appendicitis. Method Patients of any age and gender presenting with clinical history of acute appendicitis over a 4 month period were included. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of NLR were evaluated considering the cut-off values of 4.7 for acute appendicitis and 8.8 for complicated appendicitis. Results A total of 54 patients were included. Thirty-eight patients had acute appendicitis of whom 21 (55.2%) had complicated appendicitis. NLR was associated with sensitivity of 89.4%, specificity of 81.2%, PPV 91.8%, NPV of 76.5%, and accuracy of 87.0% for acute appendicitis. Moreover, it was associated with sensitivity of 61.4%, specificity of 78.9%, PPV 76.5%, NPV of 65.2%, and accuracy of 70.0% for complicated appendicitis. Conclusions NLR has acceptable sensitivity, specificity, PPV, NPV and accuracy to predict uncomplicated and complicated appendicitis with relatively better ability to predict the former. NLR can be utilised for prioritising cases for surgery, for monitoring conservatively treated patients and for patients who do not routinely undergo CT scan (pregnant or paediatric patients).

scholarly journals EP.FRI.477 Neutrophil-To-Lymphocyte Ratio (NLR) as a Predictor of Acute Appendicitis

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Sadia Tasleem ◽  
Nadia Gulnaz
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Complicated Appendicitis ◽  
Neutrophil To Lymphocyte Ratio ◽  
College Hospital ◽  
Duration Of Symptoms ◽  
Lymphocyte Ratio ◽  
Study Results ◽  
Sensitivity Specificity

Abstract The most common reason for an acute surgical assessment of the abdomen is acute appendicitis with a rate as high as 30 %There is a   lifetime risk of 8.6% and 6.7% in men and women respectively. The common age for presentation is between that of 5 and 4.4 while 28 is the median age. The objective of this study was to determine   the diagnostic accuracy   of (NLR) neutrophil-to-lymphocyte ratio to prognosticate severe/ complicated appendicitis by taking histopathology of the appendix as a gold standard. Methodology This cross-sectional validation study was conducted at the department of surgery and western vascular institute, University College Hospital Galway, Ireland retrospectively for a period of 6 months in 2016 And approximately 186 cases with appendicitis were enrolled in the study. Results The mean age of patients in this study was 29.15±9.54 years, the ratio of male to female was 1:1.7.   The sensitivity, Specificity was 97.1% and   25.2% respectively and the diagnostic accuracy of NLR was 38.7% taking histopathology as the gold standard. We observed that the sensitivity, specificity, and diagnostic accuracy of NLR   changes with the duration of symptoms in days, the sensitivity, specificity, and diagnostic accuracy of NLR was 100%, 17.0%, and 28.7%    respectively for <3days   and 92.3%, 93.75% and93.1% respectively for >3 days. Conclusion According to our study results the (NLR) neutrophil-to-lymphocyte ratio is a highly sensitive tool to predict severe/   complicated appendicitis by taking histopathology as the gold standard, but with the low value of diagnostic accuracy in terms of specificity.

scholarly journals Neutrophil-to-lymphocyte ratio in pediatric acute appendicitis

2018 ◽  
Vol 75 (1) ◽  
pp. 46-55 ◽  
Author(s):  
Nikola Stankovic ◽  
Ivan Stanojevic ◽  
Dragan Djordjevic ◽  
Zoran Kostic ◽  
Ivo Udovicic ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Clinical History ◽  
Neutrophil To Lymphocyte Ratio ◽  
Strong Positive Correlation ◽  
Strong Negative Correlation ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Mother And Child ◽  
Child Healthcare

Background/Aim. Acute appendicitis (AA) is the most frequent emergency and appendectomy is the most frequent abdominal operation in the pediatric surgery. Diagnosis of AA in children is more difficult due to a lack of cooperation and poor clinical history data, leading to significant number of misdiagnostic cases. Our aim was to explore whether neutrophil to lymphocyte ratio (NLR) may be useful in diagnosis and follow-up of AA in children. Methods. Prospective investigation of NLR values in 129 consecutive patients admitted to the Mother and Child Healthcare Institute of Serbia and referred for surgery due to AA was performed. According to the pathohistological findings, patients were divided into 3 groups: normal/early, uncomplicated (phlegmonous) and complicated (gangrenous or/and perforated) AA. Laboratory analysis was done preoperativly and on the 1st and the 3rd postoperative days. Results. Statistically significant differences of NLR values were found in the different time points in total of patients and per groups. Some statistically significant differences of NLR values among histopathological groups were recorded. Investigations of correlation of NLR and other laboratory and clinical parameters showed strong positive correlation between NLR and C-reactive protein postoperatively and between NLR and Pediatric Appendicitis Score (PAS) preoperatively. Strong negative correlation with preoperative symptoms duration (PSD) were also present. Optimal cutoff NLR value between negative and positive appendectomies was 6.14. Conclusion. NLR provides well monitoring of progression of AA in children and, its cutoff values may help in distinguishing the phases of AA. Because of that, NLR should be used in diagnosis of AA in children.

scholarly journals Neutrophil-Lymphocyte Ratio Superior to Total Leukocyte and Neutrophil in Diagnosing Acute Appendicitis Using Alvarado Score

2020 ◽  
Vol 5 (6) ◽  
pp. 1388-1393
Author(s):  
Lesni Untono ◽  
Sigit Adi Prasetyo ◽  
Ignatius Riwanto
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Alvarado Score ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Modified Alvarado Score ◽  
Point Total ◽  
Sensitivity Specificity

Background: The diagnosis of acute appendicitis must be performed quickly and accurately to reduce the risk of negative appendectomy without increasing the risk of perforation. Objective: To analyze whether Neutrophil-Lymphocyte Ratio (NL-R) in the modified Alvarado score is more accurate in diagnosing acute appendicitis in comparison with total leukocyte and neutrophil. Method: This was a cross-sectional study and the data were collected from Telogorejo Hospital Semarang (Indonesia) from November 2018 until October 2019. The best cut-off point of NL-R for predicting acute appendicitis was provided through receiver operating characteristic (ROC) curve. NL-R was used to replace total leukocyte and neutrophil to form a modified Alvarado score. Area Under Curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the original Alvarado Score and modified Alvarado score were measured. Results: Sensitivity, specificity, positive predictive value, negative predictive value of the original Alvarado score are 100%, 84.6%, 91.3%, and 100% respectively with cut-off point total score of >4.5. Sensitivity, specificity, positive predictive value, negative predictive value of modified Alvarado score were 100%, 100%, 100%, and 100% respectively with cut-off point total score of >5.5. AUC modified Alvarado Score was 1.000 and AUC original Alvarado Score was 0.985. Conclusion: Modified Alvarado score diagnoses acute appendicitis more accurately than the original Alvarado Score.

scholarly journals Comparison of RIPASA and Alvarado score in diagnosing acute appendicitis

2019 ◽  
Vol 6 (3) ◽  
pp. 740
Author(s):  
Suraj S. Kagwad ◽  
P. Karuppasamy
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Scoring System ◽  
Cost Effective ◽  
Clinical History ◽  
Alvarado Score ◽  
Negative Appendicectomy ◽  
Sensitivity Specificity ◽  
Ripasa Score

Background: Acute appendicitis is a common cause of abdominal pain and can be difficult to diagnose, especially during its early stages.  The diagnosis of acute appendicitis is based on clinical history, examination combined with investigations. The purpose of this study is to compare between the RIPASA score and Alvarado score in the diagnosis of acute appendicitis. The aim of the present study was to compare the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Alvarado and RIPASA score.Methods: The cases for the study will be sourced from cases admitted in SVMCH and RC, Puducherry during the period of November 2016 to June 2018.Results: Out of the 144 patients in our study 133 patients were diagnosed with acute appendicitis as per HPE report.As per our study, sensitivity, specificity, PPV, NPV of RIPASA and Alvarado scoring system is 96.2%, 57.1%, 97.7% and 44.4%; 81.9%,85.7%, 95.1% and 20%  respectively. The diagnostic accuracy of RIPASA score is 94.3 as compared to 82.1 of Alvarado score.Conclusions: The RIPASA scoring system is a promising and has good sensitivity, specificity and diagnostic accuracy when compared to Alvarado scoring for Asian Population.RIPASA scoring system is an easy and reliable, cost effective diagnostic tool which reduce negative appendicectomy rates and the expensive radiological investigations for the diagnosis of acute appendicitis.

scholarly journals Value of preoperative computed tomography for meso-Rex bypass in children with extrahepatic portal vein obstruction

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Huiying Wu ◽  
Ning Zhou ◽  
Lianwei Lu ◽  
Xiwen Chen ◽  
Tao Liu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Portal Vein ◽  
Predictive Value ◽  
Extrahepatic Portal Vein Obstruction ◽  
Portal Vein Obstruction ◽  
Left Portal Vein ◽  
History Of ◽  
Associated Malformations ◽  
Sensitivity Specificity

Abstract Background Extrahepatic portal vein obstruction (EHPVO) is the most important cause of hematemesis in children. Intrahepatic left portal vein and superior mesenteric vein anastomosis, also known as meso-Rex bypass (MRB), is becoming the gold standard treatment for EHPVO. We analyzed the value of preoperative computed tomography (CT) in determining whether MRB is feasible in children with EHPVO. Results We retrieved data on 76 children with EHPVO (50 male, 26 female; median age, 5.9 years) who underwent MRB (n = 68) or the Warren procedure (n = 8) from 2013 to 2019 and retrospectively analyzed their clinical and CT characteristics. The Rex recess was categorized into four subtypes (types 1–4) depending on its diameter in CT images. Of all 76 children, 7.9% had a history of umbilical catheterization and 1.3% had leukemia. Sixteen patients (20 lesions) had associated malformations. A total of 72.4% of Rex recesses could be measured by CT, and their mean diameter was 3.5 ± 1.8 mm (range 0.6–10.5 mm). A type 1, 2, 3, and 4 Rex recess was present in 9.2%, 53.9%, 11.8%, and 25.0% of patients, respectively. MRB could be performed in patients with types 1, 2, and 3, but those with type 4 required further evaluation. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of CT were 100%, 83.8%, 42.1%, 100%, and 85.5%, respectively. Conclusions Among the four types of Rex recesses on CT angiography, types 1–3 allow for the performance of MRB.

scholarly journals Neutrophil-to-lymphocyte ratio as a predictor of acute appendicitis

2014 ◽  
Vol 20 (1) ◽  
pp. 19-22 ◽  
Author(s):  
Sahin Kahramanca ◽  
Gulay Ozgehan ◽  
Duray Seker ◽  
Emre Ismail Gokce ◽  
Gaye Seker ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio

DIAGNOSTIC ACCURACY OF GRAY SCALE ULTRASONOGRAPHY VERSUS COLOR DOPPLER IN SUSPECTED CASES OF ACUTE APPENDICITIS

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Tahir Iqbal ◽  
Muhammad Usman Shahid ◽  
Ishfaq Ahmad Shad ◽  
Shahzad Karim Bhatti ◽  
Syed Amir Gilani ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Color Doppler ◽  
Diagnostic Tools ◽  
Gray Scale ◽  
Versus Color ◽  
Sensitivity Specificity

ABSTRACT: BACKGROUND: A common surgical emergency is acute appendicitis. Various diagnostic tools are available to diagnosis acute appendicitis. Radiological investigations play an important role in making accurate and early diagnosis and thus preventing morbidity associated with the disease. OBJECTIVE: To determine the diagnostic accuracy of gray scale ultrasonography versus color Doppler in suspected cases of acute appendicitis. MATERIALS AND METHODS: The study was carried in the department of Radiology of Mayo Hospital, Lahore. A total of 75 patients were enrolled of age 18-40 years, both genders who were suspected cases of acute appendicitis. All patients underwent baseline investigations along with gray scale ultrasonography and color Doppler. All patients were subjected to surgery to confirm the diagnosis and findings were subjected to statistical analysis. RESULTS: The mean age of the patients was 23.25 ±10.55 and mean transverse diameter of appendix was 8.37 ±3.39. There were 62.7% males and 37.3%females. Findings of gray scale ultrasonography and color Doppler were then correlated with surgical findings to calculate the diagnostic accuracy of these modalities. The results revealed that gray scale ultrasonography sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 92.7%, 94.32%, 95%, 91.4% and 93.3% respectively, whereas color Doppler had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 97.7%, 93.9%, 95.3%, 97% and 96% respectively. Diagnostic accuracy of both modalities together was 98.6%. CONCLUSION: Color Doppler has better diagnostic accuracy than gray scale ultrasonography for diagnosis of acute appendicitis and the combination of both modalities yields diagnostic accuracy that is similar to gold standard.

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