Diagnostic Value of Laboratory Parameters for Complicated Appendicitis: A Two-center Study

Abstract

BACKGROUND The present study aimed to examine the efficacy of the laboratory parameters with respect to complicated appendicitis. METHODS A total of 1514 cases with acute appendicitis at the Beijing Tsinghua Changgung Hospital and Aerospace Center Hospital from January 2016 to September 2021 were reviewed in this retrospective study. All cases were divided into uncomplicated and complicated appendicitis groups according to the appendix pathology. The efficacy of the laboratory parameters was evaluated in recognition of complicated appendicitis. Independent variables were analyzed by univariate and multivariate analyses. Receiver operating characteristic (ROC) curve analysis was used to identify the significant parameters in multivariate analysis. Cutoff values, sensitivity, specificity, and accuracy with the area under the curve (AUC) > 0.600 were considered significant parameters.” RESULTS Significant difference were detected in age (p < 0.001), temperature (p < 0.001), white blood cell count (WBC, p < 0.001), C-reactive protein (CRP, p < 0.001), neutrophil (p < 0.001), neutrophil-to-lymphocyte ratio (NLR, p = 0.019), platelet-to-lymphocyte ratio (PLR, p < 0.001), platelet count (p < 0.001), coefficient of variation of erythrocyte distribution width (RDW-CV, p < 0.001), standard deviation of erythrocyte distribution width (RDW-SD, p < 0.001), mean platelet volume (MPV, p < 0.001), T-bilirubin (p < 0.001), and direct bilirubin (p < 0.001) between the two groups. CRP, neutrophil, NLR, PLR, platelet count, RDW-CV, RDW-SD, MPV, and direct bilirubin were independent variables for diagnosing complicated appendicitis. CONCLUSIONS In patients with acute appendicitis, CRP > 22.95 mg/L, NLR > 5.7, serum D-bilirubin > 6.1 mmol/L, or RDW-SD > 17.7 fl are significantly associated with the presence of complicated appendicitis.