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2019, Number 1

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Cir Cir 2019; 87 (1)

Comparison of the neutrophil-to-lymphocyte ratio, SOFA score and serum procalcitonin as biomarkers of acute appendicitis

Godinez-Vidal AR, Sashida-Méndez H, Cruz-Romero CI, Bandeh-Moghaddam H, Gutiérrez-Banda CA, Gracida-Mancilla NI

Language: Spanish
References: 26
Page: 12-17
PDF size: 360.96 Kb.


ABSTRACT

Background: Acute appendicitis (AA) is one of the main causes of acute abdomen that requires urgent surgical treatment, a delay in its diagnosis and therapeutic increase in morbidity and mortality. Objective: To evaluate the usefulness of inflammatory markers as a tool to compare the neutrophil/lymphocyte ratio (NLR), the SOFA scale (Sequential Organ Failure Assessment) and the serum level of procalcitonin, total bilirubin, and see if there is a relationship as indicators and determinants of the severity of AA. Method: An retrospective, observational, and analytical study to evaluate the usefulness of the NLR as a diagnostic and severity indicator of AA, comparing it against biomarkers (BT and PCT), and against two severity scales ( APACHE II [Acute Physiology and Chronic Health Evaluation] and SOFA) and a surgical scale (Mannheim). Results: We included 82 cases from January to May 2017. 80.8% of those cases with generalized peritonitis had an NLR › 12 (p = 0.002). 66% of the cases with appendiceal perforation presented an NLR › 12 (p = 0.024). 70% of severe cases due to TB showed an NLR › 12 (p = 0.004). 75% of severe cases due to PCT have an NLR › 12 (p = 0.006). 50% of the cases with SOFA › 6 showed an NLR › 12 (U Mann-Whitney, p = 0.023). Conclusions: There is a relationship between the NLR with SOFA, total bilirubin and procalcitonin, indicating that an NLR › 12 points could be related to generalized peritonitis and perforated appendicitis.


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