Usefulness of the Pediatric Appendicitis Score and Neutrophil to Lymphocyte Ratio for Assessing the Complicated Appendicitis in Children

Abstract

Introduction: Acute appendicitis (AA) is a common surgical disease which occurs in almost all age groups, and especially in childhood. Acute appendicitis is one of the most common causes of acute abdomen. The lifetime occurrence of this disease is approximately 7%, with perforation rate of up to 20%. In spite of the well-known classical symptoms and clinical findings of acute appendicitis, early diagnosis can be sometimes challenging. For the treatment of simple appendicitis (SA) in children, the effectiveness of antibiotic treatment has been reported. We aimed to determine predictive value of combination NLR and PAS in pediatric patients with clinical suspicion of acute appendicitis and complicated appendicitis Methods: Our study was performed on 480 children admitted for suspected acute appendicitis and underwent appendectomy at the MNCMCH, Ulaanbaatar Mongolia, between May 2019 and December 2019. White blood count (WBC), Neutrophil, NLR and PAS were compared between groups. Results: The sensitivity, specificity, PPV, NPV of PAS + NLR for differentiating complicated and noncomplicated appendicitis were 86.8%, 89.4%, 92.1% and 76% respectively. The sensitivity, specificity, PPV, NPV of PAS + NLR for diagnosis of acute appendicitis were 90.5%, 68.1%, 97.68% and 32.6% respectively. Conclusion: In the era of conservative antibiotic-based management of uncomplicated acute appendicitis,

Comparison of conservative and operative treatment of uncomplicated appendicitis in the pediatric population

“…One of the most commonly used laboratory parameters when considering the diagnosis of acute appendicitis is the number of leukocytes. Some authors state that the number of neutrophils is a far more sensitive parameter and that neutrophil to lymphocyte ratio can be a useful predictor of complicated appendicitis forms [15,16]. A significant percentage of our subjects (83.64-95.24%) had leukocyte values greater than 10 × 10 9 /L, which is consistent with the diagnosis.…”