title: Clinical value of leukocyte counts in evaluation of patients with suspected appendicitis in emergency department.
abstract: BACKGROUND
  The objective of this study was to assess the value of total leukocyte count in patients presenting to the emergency department with sign and symptoms suggestive of acute appendicitis.
  
  
  METHODS
  Patient demographics, presenting sign, and symptoms, initials total leukocyte count and discharge diagnosis was documented retrospectively. Admitted patients were followed for surgical and clinical outcomes, and discharged patients followed up by telephonic interview.
  
  
  RESULTS
  Out of 116 eligible patients 48 patients was found to have acute appendicitis. Total leukocyte count >=10.000 cell/mm3 yielded a sensitivity of 89.58% and a specificity of 64.71%.The positive predictive value (PPV) was 64.18%, and the negative predictive value (NPV) was 89.80%.The positive likelihood ratio (+LR) was 2.54, and the negative likelihood ration (-LR ) was 0.16. The area under the curve for the receiver operating characteristic (ROC) curve was 0.822, which was moderately accurate.
  
  
  CONCLUSIONS
  The total leukocyte counts are helpful in the diagnosis and exclusion of acute appendicitis. The elevated leukocyte count >=10,000 cells/mm3 was statistically associated with the presence of acute appendicitis. The ROC curve suggests there is value of total leukocyte counts and has sufficient sensitivity and specificity to be clinical value in the diagnosis of acute appendicitis.
authors.affiliation: Department of Emergency Medicine, King Fahad Medical City, Riyadh, Saudia Arabia. zikitam@gmail.com
authors.forename: Mohammad Zikrullah
authors.initials: MZ
authors.lastname: Tamanna
authors.forename: Uzma
authors.initials: U
authors.lastname: Eram
authors.forename: Turki Mohsen
authors.initials: TM
authors.lastname: Al Harbi
authors.forename: Saleh Awad
authors.initials: SA
authors.lastname: Alrashdi
authors.forename: Shafkat Ullah
authors.initials: SU
authors.lastname: Khateeb
authors.forename: Saleem Ahmed
authors.initials: SA
authors.lastname: Aladhrai
authors.forename: Abdul Muthalib
authors.initials: AM
authors.lastname: Hussain
mesh_terms: D000208:Acute Disease; D001064:Appendicitis / Q000097:blood / Q000175:diagnosis*; D019540:Area Under Curve; D004630:Emergencies; D004636:Emergency Service, Hospital; D006801:Humans; D007958:Leukocyte Count; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity