title: Neutrophil-lymphocyte ratio and mean platelet volume can be a predictor for severity of acute appendicitis.
abstract: BACKGROUND
  Early diagnosis of perforation in acute appendicitis (AA) allows surgeons to select the most appropriate treatment. The aim of the present study was to determine whether preoperative neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV) could predict perforation in AA.
  
  
  METHODS
  Data collected from 413 consecutive patients with AA and 100 healthy controls were analyzed retrospectively. Patients were categorized as having had phlegmonous appendicitis, appendicitis with localized peritonitis, or appendicitis with perforation and/or gangrene. MPV and NLR values were compared among the control group and the 3 groups of patients with AA.
  
  
  RESULTS
  Means values of MPV were 9.3±8 fL for the patient group and 8.5±0.9 fL for the healthy control group (p=0.0005). Mean values of MPV by patient subgroup were 8.8±5.8 for phlegmonous appendicitis, 8.9±5.8 for localized peritonitis, and 12.8±9.7 for appendicitis with perforation and/or gangrene (p=0.005). Cut-off value of MPV was set at 8.92 to differentiate AA with perforation and/or gangrene from other types of AA. Mean NLRs of patients with phlegmonous appendicitis, appendicitis with localized peritonitis, and appendicitis with perforation and/or gangrene were 8.3±5.6, 9.1±6.2, and 10.6±6.4, respectively; p=0.023. The cut-off value for NLR was set at 7.95 to differentiate AA with perforation and/or gangrene from other types of AA.
  
  
  CONCLUSIONS
  Both NLR and MPV can be useful in predicting severity of AA.
authors.affiliation: Department of General Surgery, Marmara University Faculty of Medicine, İstanbul-Turkey.
authors.forename: Samet
authors.initials: S
authors.lastname: Yardımcı
authors.affiliation: Department of General Surgery, Marmara University Faculty of Medicine, İstanbul-Turkey. umitugurlu@gmail.com.
authors.forename: Mustafa Ümit
authors.initials: MÜ
authors.lastname: Uğurlu
authors.affiliation: Department of General Surgery, Marmara University Faculty of Medicine, İstanbul-Turkey.
authors.forename: Mümin
authors.initials: M
authors.lastname: Coşkun
authors.affiliation: Department of General Surgery, Marmara University Faculty of Medicine, İstanbul-Turkey.
authors.forename: Wafi
authors.initials: W
authors.lastname: Attaallah
authors.affiliation: Department of General Surgery, Marmara University Faculty of Medicine, İstanbul-Turkey.
authors.forename: Şevket Cumhur
authors.initials: ŞC
authors.lastname: Yeğen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000097:blood / Q000175:diagnosis*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes / Q000502:physiology; D008297:Male; D063847:Mean Platelet Volume; D009504:Neutrophils / Q000502:physiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult