SIGNIFICANCE OF NEUTROPHIL TO LYMPHOCYTE RATIO IN TREATMENT OF COMPLICATED AND NON- COMPLICATED APPENDICITIS IN A TERTIARY CARE CENTER

Abstract

Background: Appendicitis is one of the common surgical causes of acute abdomen. In atypical clinical progression and non-availability of radiological backup in primary health set ups or rural areas, surgeons nd difculty in deciding the future plan of management, which can be either conservative or surgical management or to refer the patient to higher centers. Delay in diagnosis or management may lead to perforation or peritonitis and increased morbidity and mortality. Any investigation which can predict acute appendicitis and its complications at an early stage shall be of great help. Neutrophil to Lymphocyte ratio (NLR) can be a good predictor of severity of a case of acute appendicitis. The Objective: present study aims to differentiate non-complicated, acute appendicitis from complicated appendicitis on the basis of Neutrophil to Lymphocyte ratio (NLR). A retrospective study was carried out in the department of Surgery, F Methods: AAMCH in a span of one academic year from July 2020 to June 2021. Total cases in this study were 124. Male to female ratio w Results: as 1.2:1. Most of the patients belong to the age group of 20-30 years. Out of 124 patients, 41 cases were of complicated appendicectomies and 83 cases were uncomplicated ones. The cut-off value of NLR was obtained as 5.550 with sensitivity 85.4%, specicity 68.7%, positive predictive value (PPV) 57.4%, negative predictive value (NPV) 90.5% and accuracy 84.9%. Calculation of NLR pre-operatively can be used for differentiating compli Conclusions: cated appendicitis from uncomplicated ones which will help the surgeons in periphery and rural areas to decide the future plan of management. From our study, we can state that NLR value of 5.550 can be used for this purpose.