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

Julio César Moreno‐Alfonso; Ada Molina Caballero; Alberto Pérez Martínez; María Concepción Yárnoz Irazábal

doi:10.1111/ans.70006

journal article Open Access Mar 01, 2025

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

Julio César Moreno‐Alfonso Ada Molina Caballero

Alberto Pérez Martínez

María Concepción Yárnoz Irazábal

ANZ Journal of Surgery Vol. 95 No. 3 pp. 423-429 · Wiley

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Abstract

AbstractBackgroundThe diagnosis of appendicitis in children can present several challenges, leading to an increased risk of complications. Herein, we aimed to evaluate the diagnostic value of the derived neutrophil‐to‐lymphocyte ratio (dNLR) as a novel adjunctive diagnostic tool for appendicitis.MethodsDiagnostic 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 groups of patients.ResultsOverall, 202 patients were enrolled: 101 with appendicitis (69% male, age 9.9 years) and 101 with AP (56% male, age 9.4 years). WBC, NLR, and dNLR were higher in patients in the appendicitis group than in those in the AP group (16.47 versus 11.18 × 103 cells/mm3; 9.5 versus 3.3; and 5.2 versus 2.3; P ≤ 0.0001, respectively). The sensitivity, specificity, positive predictive value, area under ROC curve, and cutoff point of dNLR 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.ConclusiondNLR is a novel and noninvasive biomarker with high accuracy for diagnosing appendicitis. Its inclusion as an additional diagnostic tool in clinical practice may aid in determining the need for further studies in cases with ambiguous presentations and a dNLR value ≥3.78.

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Details

Published: Mar 01, 2025
Vol/Issue: 95(3)
Pages: 423-429
License: View

Authors

J

Julio César Moreno‐Alfonso

Doctoral School of Navarra Universidad Pública de Navarra (UPNA) Pamplona Spain; Department of Pediatric Surgery Hospital Universitario de Navarra Pamplona Spain

A

Ada Molina Caballero

Department of Pediatric Surgery Hospital Universitario de Navarra Pamplona Spain

A

Alberto Pérez Martínez

Department of Pediatric Surgery Hospital Universitario de Navarra Pamplona Spain

M

María Concepción Yárnoz Irazábal

Doctoral School of Navarra Universidad Pública de Navarra (UPNA) Pamplona Spain; Department of General Surgery Hospital Universitario de Navarra Pamplona Spain

Cite This Article

Julio César Moreno‐Alfonso, Ada Molina Caballero, Alberto Pérez Martínez, et al. (2025). Diagnostic value of the derived neutrophil‐to‐lymphocyte ratio for acute appendicitis. ANZ Journal of Surgery, 95(3), 423-429. https://doi.org/10.1111/ans.70006

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

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