Neutrophil-to-lymphocyte ratio in pediatric acute appendicitis

Background/Aim. Acute appendicitis (AA) is the most frequent emergency and appendectomy is the most frequent abdominal operation in the pediatric surgery. Diagnosis of AA in children is more difficult due to a lack of cooperation and poor clinical history data, leading to significant number of misdi...

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Main Authors: Stanković Nikola, Stanojević Ivan, Đorđević Dragan, Kostić Zoran, Udovičić Ivo, Miličković Maja, Savić Đorđe, Grujić Blagoje, Đuričić Slaviša, Šurbatović Maja
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2018-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501600210S.pdf
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author Stanković Nikola
Stanojević Ivan
Đorđević Dragan
Kostić Zoran
Udovičić Ivo
Miličković Maja
Savić Đorđe
Grujić Blagoje
Đuričić Slaviša
Šurbatović Maja
author_facet Stanković Nikola
Stanojević Ivan
Đorđević Dragan
Kostić Zoran
Udovičić Ivo
Miličković Maja
Savić Đorđe
Grujić Blagoje
Đuričić Slaviša
Šurbatović Maja
author_sort Stanković Nikola
collection DOAJ
description Background/Aim. Acute appendicitis (AA) is the most frequent emergency and appendectomy is the most frequent abdominal operation in the pediatric surgery. Diagnosis of AA in children is more difficult due to a lack of cooperation and poor clinical history data, leading to significant number of misdiagnostic cases. Our aim was to explore whether neutrophil to lymphocyte ratio (NLR) may be useful in diagnosis and follow-up of AA in children. Methods. Prospective investigation of NLR values in 129 consecutive patients admitted to the Mother and Child Healthcare Institute of Serbia and referred for surgery due to AA was performed. According to the pathohistological findings, patients were divided into 3 groups: normal/early, uncomplicated (phlegmonous) and complicated (gangrenous or/and perforated) AA. Laboratory analysis was done preoperativly and on the 1st and the 3rd postoperative days. Results. Statistically significant differences of NLR values were found in the different time points in total of patients and per groups. Some statistically significant differences of NLR values among histopathological groups were recorded. Investigations of correlation of NLR and other laboratory and clinical parameters showed strong positive correlation between NLR and C-reactive protein postoperatively and between NLR and Pediatric Appendicitis Score (PAS) preoperatively. Strong negative correlation with preoperative symptoms duration (PSD) were also present. Optimal cutoff NLR value between negative and positive appendectomies was 6.14. Conclusion. NLR provides well monitoring of progression of AA in children and, its cutoff values may help in distinguishing the phases of AA. Because of that, NLR should be used in diagnosis of AA in children.
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spelling doaj-art-68a4e1cbf15348059f5e7f64b6f8791e2025-08-20T02:35:25ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202018-01-01751465510.2298/VSP160510210S0042-84501600210SNeutrophil-to-lymphocyte ratio in pediatric acute appendicitisStanković Nikola0Stanojević Ivan1Đorđević Dragan2Kostić Zoran3Udovičić Ivo4Miličković Maja5Savić Đorđe6Grujić Blagoje7Đuričić Slaviša8Šurbatović Maja9Mother And Child Health Care Institute of Serbia, Department of Anesthesiology and Intensive Therapy, BelgradeMilitary Medical Academy, Institute for medical research, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeMilitary Medical Academy, Clinic for Anesthesiology and Intensive Therapy, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeMilitary Medical Academy, Clinic for General Surgery, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeMilitary Medical Academy, Clinic for Anesthesiology and Intensive Therapy, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeMother And Child Health Care Institute of Serbia, Department of Abdominal Surgery, BelgradeMother And Child Health Care Institute of Serbia, Department of Abdominal Surgery, BelgradeMother And Child Health Care Institute of Serbia, Department of Neonatal Surgery, BelgradeMother And Child Health Care Institute of Serbia, Department of Clinical Pathology, Belgrade + Banjaluka University, School of Medicine, Banjaluka, Bosnia and HercegovinaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade + Military Medical Academy, Clinic for Anesthesiology and Intensive Therapy, BelgradeBackground/Aim. Acute appendicitis (AA) is the most frequent emergency and appendectomy is the most frequent abdominal operation in the pediatric surgery. Diagnosis of AA in children is more difficult due to a lack of cooperation and poor clinical history data, leading to significant number of misdiagnostic cases. Our aim was to explore whether neutrophil to lymphocyte ratio (NLR) may be useful in diagnosis and follow-up of AA in children. Methods. Prospective investigation of NLR values in 129 consecutive patients admitted to the Mother and Child Healthcare Institute of Serbia and referred for surgery due to AA was performed. According to the pathohistological findings, patients were divided into 3 groups: normal/early, uncomplicated (phlegmonous) and complicated (gangrenous or/and perforated) AA. Laboratory analysis was done preoperativly and on the 1st and the 3rd postoperative days. Results. Statistically significant differences of NLR values were found in the different time points in total of patients and per groups. Some statistically significant differences of NLR values among histopathological groups were recorded. Investigations of correlation of NLR and other laboratory and clinical parameters showed strong positive correlation between NLR and C-reactive protein postoperatively and between NLR and Pediatric Appendicitis Score (PAS) preoperatively. Strong negative correlation with preoperative symptoms duration (PSD) were also present. Optimal cutoff NLR value between negative and positive appendectomies was 6.14. Conclusion. NLR provides well monitoring of progression of AA in children and, its cutoff values may help in distinguishing the phases of AA. Because of that, NLR should be used in diagnosis of AA in children.http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501600210S.pdfappendicitisneutrophilslymphocytesdiagnosisdiagnosis,differentialprognosischild
spellingShingle Stanković Nikola
Stanojević Ivan
Đorđević Dragan
Kostić Zoran
Udovičić Ivo
Miličković Maja
Savić Đorđe
Grujić Blagoje
Đuričić Slaviša
Šurbatović Maja
Neutrophil-to-lymphocyte ratio in pediatric acute appendicitis
Vojnosanitetski Pregled
appendicitis
neutrophils
lymphocytes
diagnosis
diagnosis,differential
prognosis
child
title Neutrophil-to-lymphocyte ratio in pediatric acute appendicitis
title_full Neutrophil-to-lymphocyte ratio in pediatric acute appendicitis
title_fullStr Neutrophil-to-lymphocyte ratio in pediatric acute appendicitis
title_full_unstemmed Neutrophil-to-lymphocyte ratio in pediatric acute appendicitis
title_short Neutrophil-to-lymphocyte ratio in pediatric acute appendicitis
title_sort neutrophil to lymphocyte ratio in pediatric acute appendicitis
topic appendicitis
neutrophils
lymphocytes
diagnosis
diagnosis,differential
prognosis
child
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501600210S.pdf
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