Role of neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department

NALÇACIOĞLU, Hülya; ALTUNER TORUN, Yasemin; celik, binnaz; OZCATAL, MUSTAFA

doi:10.5505/tjtes.2018.06709

Role of neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department

Binnaz Çelik, (Kayseri Eğitim ve Araştırma Hastanesi, Pediatri Kliniği, Kayseri, Türkiye)

Hülya Nalçacıoğlu, (Kayseri Eğitim ve Araştırma Hastanesi, Çocuk Nefroloji Kliniği, Kayseri, Türkiye)

Mustafa Özçatal, (Kayseri Eğitim ve Araştırma Hastanesi, Çocuk Cerrahi Kliniği, Kayseri)

Yasemin Altuner Torun (Kayseri Eğitim ve Araştırma Hastanesi, Çocuk Hematoloji-Onkoloji Kliniği, Kayser, Türkiye)

Ulusal Travma ve Acil Cerrahi Dergisi

14 2

Yıl: 2019 Cilt: 25 Sayı: 3 Sayfa Aralığı: 222 - 228 Metin Dili: İngilizce DOI: 10.5505/tjtes.2018.06709 İndeks Tarihi: 11-06-2020

Role of neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department

Öz:

BACKGROUND: The objective of this research was to evaluate the potential clinical utility of baseline hematological parametersmeasured on admission as adjuncts in the identification of complicated and uncomplicated appendicitis in children.METHODS: The records of a total of 334 pediatric patients who underwent curative surgery for acute appendicitis (AA) between2015 and 2016 were retrospectively investigated. The patients were categorized as complicated or uncomplicated appendicitis basedon the histopathological reports. The clinical features and baseline hematological parameters of leukocyte count, neutrophil percentage, thrombocyte count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), redcell distribution width (RDW), and platelet distribution width (PDW) of the groups were compared.RESULTS: Complicated AA was determined in 36 (10.8%) patients. The white blood cell count (WBC) (p<.001), neutrophil percentage (p<.001), NLR (p<.001), and PLR (p=.004) were higher in the complicated appendicitis group compared with the uncomplicatedgroup, while the RDW, MPV, and PDW levels were uninformative. Analysis of receiver operating characteristic curves yielded the cutoff values of 14.870 cell/mm3 for WBC (area under the curve [AUC]: 0.675; sensitivity: 86.1%; specificity: 41.6%), 10.4 for NLR (AUC:0.717; sensitivity: 61.1%; specificity: 73.2%), and 284 for PLR (AUC: 0.647; sensitivity: 42%; specificity: 86%) were found to be the bestpredictive values for the determination of complicated acute appendicitis.CONCLUSION: The present study demonstrated that AA patients with higher NLR and PLR levels might be more likely to developa complication. The NLR and PLR values combined with a physical examination, imaging studies, and other laboratory tests may help clinicians to identify high-risk AA patients in the emergency department.

Anahtar Kelime:

Pediatrik acil serviste komplike apandisitin belirlenmesinde nötrofil-lenfosit oranı ve trombosit-lenfosit oranının rolü

Öz:

AMAÇ: Çocuklarda komplike ve komplike olmayan apandisitin saptanmasında yardımcı olarak başlangıç hematolojik parametrelerin olası klinik faydalarını değerlendirmek amaçlandı. GEREÇ VE YÖNTEM: 2015’ten 2016’ya kadar akut apandisit için küratif cerrahi geçiren 334 pediatrik hasta geriye dönük olarak incelendi. Hastalar histopatolojik raporlara dayanarak komplike veya komplike olmayan apandisit olarak sınıflandırıldı. Klinik bulgular ve temel hematolojik parametrelerden lökosit sayısı, nötrofil yüzdesi, trombosit sayısı, nötrofil-lenfosit oranı (NLR), trombosit-lenfosit oranı (PLR), ortalama trombosit hacmi, kırmızı hücre dağılım genişliği, trombosit dağılım genişliği gruplar arasında karşılaştırıldı. BULGULAR: Komplike akut apandisit 36 (%10.8) hastada bulundu. Komplike apandisitte WBC (p<0.001), nötrofil yüzdesi (p<0.001), NLR (p<0.001), PLR (p=.004) komplike olmayan gruba göre daha yüksek iken, RDW, MPV, PDW düzeyleri anlamlı fark bulunmadı. ROC eğrilerinin analizi, WBC için 14.870 hücre/mm3(eğri altındaki alan [AUC], 0.675; duyarlılık, %86.1; özgüllük, %41.6), NLR için 10.4 (AUC, 0.717; duyarlılık, %61.1, özgüllük, %73.2), PLR için 284 (AUC, 0.647; duyarlılık, %42; özgüllük, %86) komplike akut apandisitin belirlenmesinde en iyi kestirim değerler olarak bulundu. TARTIŞMA: Bu çalışma, daha yüksek NLR ve PLR düzeylerine sahip akut apandisitli hastalarda komplikasyon gelişme olasılığının daha yüksek olabileceğini göstermiştir. Klinisyenlerin acil servisteki yüksek riskli akut apandisit hastalarını tespit etmelerine yardımcı olmak için fizik muayene, görüntüleme çalışmaları ve diğer laboratuvar testleri ile birlikte NLR ve PLR kullanılmasını öneririz.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	celik b, NALÇACIOĞLU H, OZCATAL M, ALTUNER TORUN Y (2019). Role of neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department. , 222 - 228. 10.5505/tjtes.2018.06709
Chicago	celik binnaz,NALÇACIOĞLU Hülya,OZCATAL MUSTAFA,ALTUNER TORUN Yasemin Role of neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department. (2019): 222 - 228. 10.5505/tjtes.2018.06709
MLA	celik binnaz,NALÇACIOĞLU Hülya,OZCATAL MUSTAFA,ALTUNER TORUN Yasemin Role of neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department. , 2019, ss.222 - 228. 10.5505/tjtes.2018.06709
AMA	celik b,NALÇACIOĞLU H,OZCATAL M,ALTUNER TORUN Y Role of neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department. . 2019; 222 - 228. 10.5505/tjtes.2018.06709
Vancouver	celik b,NALÇACIOĞLU H,OZCATAL M,ALTUNER TORUN Y Role of neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department. . 2019; 222 - 228. 10.5505/tjtes.2018.06709
IEEE	celik b,NALÇACIOĞLU H,OZCATAL M,ALTUNER TORUN Y "Role of neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department." , ss.222 - 228, 2019. 10.5505/tjtes.2018.06709
ISNAD	celik, binnaz vd. "Role of neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department". (2019), 222-228. https://doi.org/10.5505/tjtes.2018.06709

APA	celik b, NALÇACIOĞLU H, OZCATAL M, ALTUNER TORUN Y (2019). Role of neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department. Ulusal Travma ve Acil Cerrahi Dergisi, 25(3), 222 - 228. 10.5505/tjtes.2018.06709
Chicago	celik binnaz,NALÇACIOĞLU Hülya,OZCATAL MUSTAFA,ALTUNER TORUN Yasemin Role of neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department. Ulusal Travma ve Acil Cerrahi Dergisi 25, no.3 (2019): 222 - 228. 10.5505/tjtes.2018.06709
MLA	celik binnaz,NALÇACIOĞLU Hülya,OZCATAL MUSTAFA,ALTUNER TORUN Yasemin Role of neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department. Ulusal Travma ve Acil Cerrahi Dergisi, vol.25, no.3, 2019, ss.222 - 228. 10.5505/tjtes.2018.06709
AMA	celik b,NALÇACIOĞLU H,OZCATAL M,ALTUNER TORUN Y Role of neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department. Ulusal Travma ve Acil Cerrahi Dergisi. 2019; 25(3): 222 - 228. 10.5505/tjtes.2018.06709
Vancouver	celik b,NALÇACIOĞLU H,OZCATAL M,ALTUNER TORUN Y Role of neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department. Ulusal Travma ve Acil Cerrahi Dergisi. 2019; 25(3): 222 - 228. 10.5505/tjtes.2018.06709
IEEE	celik b,NALÇACIOĞLU H,OZCATAL M,ALTUNER TORUN Y "Role of neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department." Ulusal Travma ve Acil Cerrahi Dergisi, 25, ss.222 - 228, 2019. 10.5505/tjtes.2018.06709
ISNAD	celik, binnaz vd. "Role of neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in identifying complicated appendicitis in the pediatric emergency department". Ulusal Travma ve Acil Cerrahi Dergisi 25/3 (2019), 222-228. https://doi.org/10.5505/tjtes.2018.06709