TITLE:
Usefulness of the Pediatric Appendicitis Score and Neutrophil to Lymphocyte Ratio for Assessing the Complicated Appendicitis in Children
AUTHORS:
Erdenetsetseg Chuluun, Bayartsetseg Ankhbayar, Ganbayar Ganzorig, Ganbayar Luuzan, Davaalkham Dambadarjaa, Zorig Dungerdorj, Puntsag Chimedtseye
KEYWORDS:
Acute Appendicitis, Complicated Appendicitis, Neutrophil to Lymphocyte Ratio, Antibiotic, Pediatric Patient
JOURNAL NAME:
Open Journal of Clinical Diagnostics,
Vol.10 No.4,
December
30,
2020
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, we advocate that combination of NLR and PAS is a useful aid in
predicting complicated appendicitis.