Value of neutrophil-to-platelet ratio, immature granulocyte-to-lymphocyte ratio, red blood cell distribution width-to-lymphocyte ratio in differentiating complicated acute appendicitis

Abstract

BACKGROUND: The discovery that medical treatment could be successful in cases with uncomplicated acute appendicitis (UCAA) has revealed the need for successfully differentiating cases with complicated acute appendicitis (CAA). The present study examined the usability of neutrophil-to-platelet ratio (NPR), immature granulocyte-to-lymphocyte ratio, and red blood cell distribution width-to-lymphocyte ratio (RDWLR) in the CAA/UCAA differentiation. METHODS: A retrospective evaluation was made of patients undergoing appendectomy between January 2019 and December 2020. According to pathological and clinical findings, the patients were divided into negative appendectomy, CAA and UCAA groups. Laboratory parameters and associated ratios were evaluated by comparing the groups. RESULTS: The study included 348 patients. Of the patients, 11.2% had CAA, 81.6% had UCAA, and 7.2% had negative appendectomy. The neutrophil-to-lymphocyte ratio (AUC=0.742), platelet-to-lymphocyte ratio (AUC=0.707), immature granulocyte-to-lymphocyte ratio (AUC=0.782), monocyte-to-lymphocyte ratio (AUC=0.720), and RDWLR (AUC=0.711) were found significant in the differentiation between complicated and uncomplicated AA. The NPR (AUC=0.789) was found to be significant in the differentiation between positive and negative appendectomy. CONCLUSION: It was concluded that the immature granulocyte-to-lymphocyte ratio, NPR, monocyte-to-lymphocyte, and RDWLR, which have not been previously studied in patients with acute appendicitis (AA), could be used to differentiate between complicated and uncomplicated AA groups.