White blood cell count is a poor predictor of severity of disease in the diagnosis of appendicitis.
The white blood cell (WBC) count is considered to be a useful test in the diagnosis of appendicitis. The purpose of this study was to examine the clinical features of patients with normal WBC appendicitis and also to determine whether a higher WBC count correlates with a more advanced stage of appendicitis. Patients with pathologically confirmed appendicitis from January 1989 to December 1994 were included in the study (n = 1919). The age, gender, temperature, length of hospital stay, and severity of disease (1 = acute appendicitis; 2 = gangrenous appendicitis; 3 = perforated appendicitis with abscess formation; 4 = appendicitis with diffuse peritonitis) were compared for patients with a normal WBC count (range, 3.8-10.9) versus those who had an elevated WBC count. A normal WBC count was seen in 11 per cent of patients (n = 209). There was no difference in age, temperature, gender, or severity of disease in the patients with a normal WBC count compared with those with an elevated WBC count (P > 0.05). The severity of disease of patients with a normal WBC count were: 1 = 58 per cent; 2 = 13 per cent; 3 = 7 per cent; and 4 = 22 per cent. For patients with an elevated WBC count the scores were: 1 = 57 per cent; 2 = 17 per cent; 3 = 13 per cent; and 4 = 14 per cent. The proportion of gangrenous and perforated appendicitis in the patients with a normal WBC count is the same as in the patients with an elevated WBC count.
Coleman
C
C
Olive View-University of California at Los Angeles Medical Center, Sylmar 91342, USA.
Thompson
J E
JE
Bennion
R S
RS
Schmit
P J
PJ
D000038:Abscess / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001064:Appendicitis / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D001065:Appendix / Q000473:pathology; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D005734:Gangrene / Q000473:pathology; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D007902:Length of Stay; D007958:Leukocyte Count; D008297:Male; D011379:Prognosis; D012016:Reference Values; D012422:Rupture, Spontaneous; D012680:Sensitivity and Specificity