Turkish Journal of Colorectal Disease (Sep 2020)

Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age

  • Uğur Topal,
  • Muhammet Akyüz,
  • Erdoğan Mütevelli Sözüer,
  • Şadi Yenel İsaoğulları,
  • Fatih Dal,
  • Tutkun Talih

DOI
https://doi.org/10.4274/tjcd.galenos2020.2020-2-4
Journal volume & issue
Vol. 30, no. 3
pp. 157 – 163

Abstract

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Aim:Acute appendicitis (AA) is one of the most common emergency surgical pathologies. The tests used in the differential diagnosis of these patients need to be quick, easy to access and cheap. Discussions continue about the value of laboratory tests in the diagnosis of AA. In this study, we aimed to determine the diagnostic value of platelet/lymphocyte ratio (PLR) in the diagnosis of AA and to determine its diagnostic value in different age groups.Method:Patients who underwent appendectomy after a preliminary diagnosis of AA between January 2015 and January 2020 were enrolled. Patients were divided into two groups, according to the postoperative pathology finding: group 1 (negative appendectomy) and group 2 (AA). In addition, groups were divided into subgroups based on age: 18-39 years, 40-59 years and 60 years and older. Platelet and lymphocyte counts and PLR were compared between groups and subgroups. In diagnostic accuracy evaluation ROC curve analysis was used; p<0.05 value was considered statistically significant.Results:A total of 875 patients were included in the study. There were 152 patients in group 1 (negative appendectomy) and 723 patients in group 2 (AA). Mean age was similar between the groups (33.43 vs 35.33, p=0.152). In univariate analysis, lymphocyte count (p=0.033) and platelet count (p=0.002) were found to be significant. In multivariate analysis, lymphocyte count (p=0.000), platelet count (p=0.012) and PLR (odds ratio: 0.632; 95% confidence interval (minimum-maximum) 0.440-0.908; p=0.013) were found to be significant. When the ROC curve analysis was performed, the sensitivity of PLR regardless of age was 70.82% and the specificity was 40.13% (p=0.093). The highest specificity was in the 40-59 years age group (85.71%), the highest sensitivity was in the age group 60 and older (78.79%) (p=0.002).Conclusion:PLR cannot be used alone in the diagnosis of AA. Normal PLR values cannot exclude AA alone. In addition, the PLR diagnostic value varies according to age groups. The surgeon’s clinical evaluation should continue to be a priority in the diagnosis of AA.

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