Diagnostic value of the derived neutrophil-to-lymphocyte ratio for acute appendicitis

Background: The diagnosis of appendicitis in children can present several challenges,leading to an increased risk of complications. Herein, we aimed to evaluate the diagnosticvalue of the derived neutrophil-to-lymphocyte ratio (dNLR) as a novel adjunctive diagnostictool for appendicitis.Methods: Dia...

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Detalles Bibliográficos
Autores: Moreno Alfonso, Julio César, Molina Caballero, Ada, Pérez Martínez, Alberto, Yárnoz Irazábal, María Concepción
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universidad Pública de Navarra
Repositorio:Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
OAI Identifier:oai:academica-e.unavarra.es:2454/54998
Acceso en línea:https://hdl.handle.net/2454/54998
Access Level:acceso abierto
Palabra clave:Abdominal pain
Appendicitis
Biomarker
Derived neutrophil-to-lymphocyte ratio
Diagnosis
Neutrophil
Descripción
Sumario:Background: The diagnosis of appendicitis in children can present several challenges,leading to an increased risk of complications. Herein, we aimed to evaluate the diagnosticvalue of the derived neutrophil-to-lymphocyte ratio (dNLR) as a novel adjunctive diagnostictool for appendicitis.Methods: Diagnostic study of patients with appendicitis and non-surgical abdominal pain(AP) admitted to our hospital between 2020 and 2022. White blood cell count (WBC),neutrophil-to-lymphocyte ratio (NLR), and dNLR were compared between the two groupsof patients.Results: Overall, 202 patients were enrolled: 101 with appendicitis (69% male, age9.9 years) and 101 with AP (56% male, age 9.4 years). WBC, NLR, and dNLR were higherin patients in the appendicitis group than in those in the AP group (16.47 versus11.18 10 3 cells/mm 3; 9.5 versus 3.3; and 5.2 versus 2.3; P ≤ 0.0001, respectively). Thesensitivity, specificity, positive predictive value, area under ROC curve, and cutoff point ofdNLR for the diagnosis of appendicitis were 71%, 74%, 73%, 0.811, and 3.78, respectively.The positive likelihood ratios for WBC, NLR, and dNLR were 1.95, 2.05 and 2.77.Conclusion: dNLR is a novel and noninvasive biomarker with high accuracy for diagnosingappendicitis. Its inclusion as an additional diagnostic tool in clinical practice may aid in determin-ing the need for further studies in cases with ambiguous presentations and a dNLR value ≥3.78.