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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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
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spelling Diagnostic value of the derived neutrophil-to-lymphocyte ratio for acute appendicitisMoreno Alfonso, Julio CésarMolina Caballero, AdaPérez Martínez, AlbertoYárnoz Irazábal, María ConcepciónAbdominal painAppendicitisBiomarkerDerived neutrophil-to-lymphocyte ratioDiagnosisNeutrophilBackground: 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.Open access funding provided by Universidad Pública de Navarra.WileyCiencias de la SaludOsasun ZientziakUniversidad Pública de Navarra / Nafarroako Unibertsitate Publikoa2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2454/54998reponame:Academica-e. Repositorio Institucional de la Universidad Pública de Navarrainstname:Universidad Pública de NavarraInglés© 2025 The Author(s). This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License.https://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:academica-e.unavarra.es:2454/549982026-06-17T12:41:47Z
dc.title.none.fl_str_mv Diagnostic value of the derived neutrophil-to-lymphocyte ratio for acute appendicitis
title Diagnostic value of the derived neutrophil-to-lymphocyte ratio for acute appendicitis
spellingShingle Diagnostic value of the derived neutrophil-to-lymphocyte ratio for acute appendicitis
Moreno Alfonso, Julio César
Abdominal pain
Appendicitis
Biomarker
Derived neutrophil-to-lymphocyte ratio
Diagnosis
Neutrophil
title_short Diagnostic value of the derived neutrophil-to-lymphocyte ratio for acute appendicitis
title_full Diagnostic value of the derived neutrophil-to-lymphocyte ratio for acute appendicitis
title_fullStr Diagnostic value of the derived neutrophil-to-lymphocyte ratio for acute appendicitis
title_full_unstemmed Diagnostic value of the derived neutrophil-to-lymphocyte ratio for acute appendicitis
title_sort Diagnostic value of the derived neutrophil-to-lymphocyte ratio for acute appendicitis
dc.creator.none.fl_str_mv Moreno Alfonso, Julio César
Molina Caballero, Ada
Pérez Martínez, Alberto
Yárnoz Irazábal, María Concepción
author Moreno Alfonso, Julio César
author_facet Moreno Alfonso, Julio César
Molina Caballero, Ada
Pérez Martínez, Alberto
Yárnoz Irazábal, María Concepción
author_role author
author2 Molina Caballero, Ada
Pérez Martínez, Alberto
Yárnoz Irazábal, María Concepción
author2_role author
author
author
dc.contributor.none.fl_str_mv Ciencias de la Salud
Osasun Zientziak
Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
dc.subject.none.fl_str_mv Abdominal pain
Appendicitis
Biomarker
Derived neutrophil-to-lymphocyte ratio
Diagnosis
Neutrophil
topic Abdominal pain
Appendicitis
Biomarker
Derived neutrophil-to-lymphocyte ratio
Diagnosis
Neutrophil
description 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.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2454/54998
url https://hdl.handle.net/2454/54998
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv https://creativecommons.org/licenses/by-nc/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Wiley
publisher.none.fl_str_mv Wiley
dc.source.none.fl_str_mv reponame:Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
instname:Universidad Pública de Navarra
instname_str Universidad Pública de Navarra
reponame_str Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
collection Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
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repository.mail.fl_str_mv
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