Neutrophil-to-lymphocyte ratio in pediatric acute appendicitis

Stanković, Nikola; Stanojević, Ivan; Djordjević, Dragan; Kostić, Zoran; Udovičić, Ivo; Milickovic, Maja; Savić, Djordje; Grujić, Blagoje; Djuričić, Slaviša; Šurbatović, Maja

doi:10.2298/vsp160510210s

Cited by 5 publications

(5 citation statements)

References 18 publications

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“…Some studies showed that NLR appears to have greater diagnostic accuracy than WBC [19]. In our previous publication we confirmed a faster activation of neutrophils and NLR increase, and delayed increase of CRP, in pediatric AA [20, 21]. Therefore usefulness of NLR in early diagnosis of AA is superior to CRP, but still not sufficiently reliable.…”

Section: Discussionmentioning

confidence: 72%

Possible cytokine biomarkers in pediatric acute appendicitis

et al. 2019

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Background Diagnosis of acute appendicitis (AA) and decisions about its treatment remain among the most common dilemmas of pediatric surgical teams. Monitoring of immune response may be of importance for this purpose. Our aim was to measure and analyze serum and peritoneal fluid cytokines, in children who had undergone surgery for suspected AA. Methods Prospective investigation of serum and peritoneal fluid cytokine values was performed in 127 consecutive patients. According to the pathohistological findings, patients were divided into three groups: normal/early, uncomplicated and complicated AA. Determination of cytokine concentrations for 20 different cytokines was done using a commercial flow cytometry kit: Human Inflammation 20 plex BMS 819. Results Statistically significant differences in serum cytokine values between pathohistological groups were found for IP-10, MIP-1α and IL-10. Preoperative cut-off values of IP-10, MIP-1α and IL-10 between groups were obtained using ROC curve analysis. Positive correlations between serum and peritoneal concentrations were recorded for most of the analyzed cytokines. Conclusion IP-10, MIP-1α and IL-10 showed potential in assessment of AA in children. Confirmatory studies with a larger number of patients are required to prove reliability of these biomarkers.

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Section: Discussionmentioning

confidence: 72%

Possible cytokine biomarkers in pediatric acute appendicitis

et al. 2019

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“…NLR was measured in three different time points with regard to surgery: preoperative, on day 1, and day 3 postoperatively. We demonstrated that NLR provides good monitoring of progression of AA in children and that its cutoff values may help in distinguishing the phases of AA; therefore, it could be used in diagnosis of AA in pediatric population [ 47 ]. In the literature available to us, we did not find any studies regarding MLR and PLR with repetitive measurements.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Mean Platelet Volume-to-Platelet Count Ratio as Biomarkers in Critically Ill and Injured Patients: Which Ratio to Choose to Predict Outcome and Nature of Bacteremia?

Djordjević

Rondović

Šurbatović

et al. 2018

Mediators of Inflammation

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Background Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume-to-platelet count (MPV/PC) ratio are readily available parameters that might have discriminative power regarding outcome. The aim of our study was to assess prognostic value of these biomarkers regarding outcome in critically ill patients with secondary sepsis and/or trauma. Methods A total of 392 critically ill and injured patients, admitted to surgical ICU, were enrolled in a prospective observational study. Leukocyte and platelet counts were recorded upon fulfilling Sepsis-3 criteria and for traumatized Injury Severity Score > 25 points. Patients were divided into four subgroups: peritonitis, pancreatitis, trauma with sepsis, and trauma without sepsis. Results NLR and MPV/PC levels were significantly higher in nonsurvivors (AUC/ROC of 0.681 and 0.592, resp., in the peritonitis subgroup; 0.717 and 0.753, resp., in the pancreatitis subgroup); MLR and PLR did not differ significantly. There was no significant difference of investigated biomarkers between survivors and nonsurvivors in trauma patients with and without sepsis except for PLR in the trauma without sepsis subgroup (significantly higher in nonsurvivors, AUC/ROC of 0.719). Independent predictor of lethal outcome was NLR in the whole cohort and in the peritonitis subgroup as well as MPV in the pancreatitis subgroup. Also, there were statistically significant differences in MPV/PC, MLR, and PLR values regarding nature of bacteremia. In general, the lowest levels had been found in patients with Gram-positive blood cultures. Conclusions NLR and MPV were very good independent predictors of lethal outcome. For the first time, we demonstrate that nature of bacteremia influences MPV/PC, MLR, and PLR. In heterogeneous cohort subgroup, analysis is essential.

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“…We did not find a significant correlation of MPXI neither with the overall PAS nor with the single parameters of this score, including the absolute number of leukocytes and the percentage of neutrophils. Additionaly, in our previous article we showed the lack of significant correlation between the MPXI and neutrophil-to-lymphocyte ratio (NLR) 22 .…”

Section: Discussionmentioning

confidence: 89%

Neutrophil myeloperoxidase index in pediatric acute appendicitis

et al. 2019

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Background/Aim. Diagnosis of acute appendicitis (AA) remains the most common dilemma of pediatric surgical team. Our aim was to determine whether the neutrophil myeloperoxidase index (MPXI), in combination with other laboratory and clinical parameters, can be useful in diagnosis and follow-up of AA in children. Methods. A prospective investigation of MPXI values in 117 consecutive patients, planned for the surgical intervention due to AA, was performed. The patients were stratified into three groups according to the intraoperative finding: the normal/early, uncomplicated and complicated AA. Laboratory analyses were done preoperativly, on the 1st and on the 3rd postoperative days. Results. The statistically significant difference of MPXI values between the uncomplicated and complicated appendicitis before surgery and the positive correlations between the MPXI and C-reactive protein, as well as interleukin-6, before surgery were found. Postoperatively, in the group of uncomplicated, as well as complicated AA, a significant decrease of MPXI was recorded. Conclusion. The MPXI may be used as an informative biomarker in the follow-up of AA in children. A wide reference range for the MPXI and individual differences in the values of MPXI in the healthy children, generate difficulties for its use for the initial diagnosis of acute appendicitis. Usefulness of MPXI determination decreases with a delayed diagnosis.

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Neutrophil-to-lymphocyte ratio in pediatric acute appendicitis

Cited by 5 publications

References 18 publications

Possible cytokine biomarkers in pediatric acute appendicitis

Possible cytokine biomarkers in pediatric acute appendicitis

Neutrophil-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Mean Platelet Volume-to-Platelet Count Ratio as Biomarkers in Critically Ill and Injured Patients: Which Ratio to Choose to Predict Outcome and Nature of Bacteremia?

Neutrophil myeloperoxidase index in pediatric acute appendicitis

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