title: Neutrophil to Lymphocyte Ratio on Appendectomy of Geriatric and Nongeriatric Patients.
abstract: OBJECTIVE
  Acute appendicitis is the most frequent emergency procedure that requires acute surgical intervention. The mortality risk is higher in geriatric patients. There is not a single parameter to diagnose it easily and negative appendectomy is traditionally accepted however the operation itself can cause morbidity and mortality especially in elderly patients. The neutrophil-to-lymphocyte ratio is a predictor of acute inflammation and was recently studied for the diagnosis of AA. The aim of this study is to analyze the diagnostic value of NLR on positive appendectomy rates amongst geriatric and nongeriatric patients.
  
  
  METHODS
  755 patients admitted to the emergency department, with abdominal pain who underwent urgent laparotomy after diagnosed as acute appendicitis. Patients' ages, genders, laboratory results, and intraoperative findings were collected. Geriatric patients were analyzed in group one, and nongeriatric patients were in group 2. Groups then sorted into subgroups by means of positive and negative appendectomies.
  
  
  RESULTS
  Although NLR was higher in positive appendectomy subgroup in group 1 it was not statistically significant. NLR could not independently predict positive appendectomy in geriatric patients. In group 2, male gender was significantly higher in the positive appendectomy group (p < 0.001). NLR was also significantly higher in the positive appendectomy group (p < 0.001). In group 2 NLR could independently predict positive appendectomy (p < 0.001).
  
  
  CONCLUSIONS
  NLR could not predict positive appendectomy rates in the geriatric population but could in the nongeriatric patient group. To find the optimal NLR levels, prospective randomized studies are needed.
authors: a Department of Emergency Medicine , Faculty of Medicine, Kafkas University , Kars , Turkey.
authors: Gulsen
authors: G
authors: Cigsar
authors: b General Surgery , Ministry of Health Kars State Hospital , Kars , Turkey.
authors: Ali Cihat
authors: AC
authors: Yildirim
authors: c Department of General Surgery , Faculty of Medicine, Kafkas University , Kars , Turkey.
authors: Turgut
authors: T
authors: Anuk
authors: d Ministry of Health Diskapi Research and Education Hospital , General Surgery , Ankara , Turkey.
authors: Hakan
authors: H
authors: Guzel
authors: a Department of Emergency Medicine , Faculty of Medicine, Kafkas University , Kars , Turkey.
authors: Elnare
authors: E
authors: Gunal
authors: e Republic of Turkey Social Security Institution , Ankara , Turkey.
authors: Saygı
authors: S
authors: Gulkan
authors: f General Surgery , Ministry of Health Malkara State Hospital , Tekirdag , Turkey.
authors: Burak
authors: B
authors: Irem
authors: g General Surgery , Ministry of Health Kanuni Sultan Suleyman Research and Education Hospital , Istanbul , Turkey.
authors: Caglar
authors: C
authors: Bilgin
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy; D001064:Appendicitis / Q000276:immunology* / Q000601:surgery; D006801:Humans; D018655:Lymphocyte Count; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
keywords: acute appendicitis; geriatrics; lymphocyte; neutrophil