Exploring the Impact of Neutrophil to Lymphocyte Ratio in Predicting Acute Appendicitis on Rohingya Children in Cox’s Bazar

Impact of Neutrophil to Lymphocyte Ratio in Predicting Acute Appendicitis

Abstract

Background: Acute appendicitis is one of the world's most frequent abdominal events in among pediatric group. Several helpful diagnostic methods are available for acute appendicitis, including evaluation of clinical symptoms, scoring systems, and imaging methods, in the present study, therefore, we tried to explain the usefulness of the Neutrophil-to-lymphocyte ratio (NLR) as a predictor of Rohingya children's acute appendicitis in Cox's Bazar. Subjects and Methods: This is a hospital based prospective observational study that was conducted at Palong General Hospital, over a period of 1.5 years from 8th February 2017 to 7th August 2018.The diagnosis of appendicitis of total 100 patients were confirmed by clinically & histopathologically and included in this study. Sample was selected by purposive consecutive sampling technique. Results: In the study, out of 24 patients of acute obstructive appendicitis in 5(20.8%) cases NLR was in between 6.1-8.0 and in 19(79.1%) cases it was ≥8.1. On the other hand, in 53(69.7%) patients of acute catarrhal appendicitis NLR was in between 6.1-8.0. The mean NLR value in acute catarrhal appendicitis was 5.2±4.1 and in acute obstructive appendicitis was 8.6±1.7, and there was a significant difference in NLR values between the groups. The p-value is < 0.00001. The result is significant at p <0.05. So, NLR shows a significant association with acute appendicitis in patients. The sensitivity and specificity of NLR to predict the diagnosis of acute appendicitis was 95.6% and 97.4% respectively. Conclusion: According to the findings of this study, the NLR is a good predictor of acute appendicitis and can be used in conjunction with other diagnostic methods.