Akut Apandisit Olgularında Nötrofil/Lenfosit Oranının Tanıda ve Hastalığın Şiddetini Belirlemedeki Prediktif Değeri

Year 2016, Volume: 43 Issue: 2, 279 - 284, 01.06.2016

Tunç Eren Ercüment Tombalak Buşra Burcu İbrahim Ali Özemir Metin Leblebici Sedat Ziyade Özgür Ekinci Orhan Alimoğlu

Abstract

Amaç: Akut apandisit olgularında ameliyat öncesi rutin
hemogram tetkikinde saptanan nötrofil/lenfosit oranının
(NLO) tanı koymada ve gangrene/perfore apandisiti ön
görmedeki etkisini incelemeyi amaçladık.
Yöntemler: Ocak 2013 ile Eylül 2014 arasında apendektomi
uygulanan 162 hastanın yaş, cinsiyet, c-reaktif
protein (CRP), lökosit, nötrofil, lenfosit sayısı ve NLO ile
ameliyat sonrası histopatolojik inceleme sonuçlarını içeren
verileri retrospektif olarak incelendi ve istatistiksel olarak
değerlendirildi.
Bulgular: Çalışma grubundaki hastaların 97’si (%59,9)
erkek ve 65’i (%40,1) kadındı. Ortalama yaş 36,01 (18-90)
hesaplandı. Ameliyat sonrası patoloji sonuçlarına göre
21 (%12,96) hastada normal apendiks ve 141 (%87,04)
hastada akut apandisit saptandı. 41 (%25,31) hastada ise
gangrene/perfore apandisit varlığı gözlendi. Akut apandisit
olgularında lenfosit sayısı anlamlı derecede düşük iken
CRP düzeyleri, lökosit sayısı, nötrofil sayısı ve NLO’nun
anlamlı düzeyde yüksek olduğu gözlendi (p< 0,05). NLO
≥4,0 olan olgularda akut apandisit tanısı olasılığının 16,9
kat daha yüksek olduğu saptandı [p< 0,01; Odds oranı
(Odds ratio - OR):16,864; %95 Güvenlik aralığı (Confidence
interval - CI): 4,696-60,568]. NLO ≥4,5 olan olgularda
ise apendiseal gangren/perforasyon riskinin 3,2 kat
daha yüksek olduğu saptandı [p<0,01; OR: 3,258; %95
CI: 1,468-7,228].
Sonuç: Nötrofil/lenfosit oranı (NLO); akut apandisit tanısı
koymada ve gangrene/perfore apandisiti ön görmede fizik
muayene ve diğer tanısal yöntemlere yardımcı ve kullanışlı
bir değişken olarak kabul edilebilir.

Keywords

Nötrofil/lenfosit oranı, akut apandisit, apendiseal gangren/perforasyon

Predictive value of Neutrophil/Lymphocyte Ratio for the Diagnosis and Severity of Disease in Acute Appendicitis

Abstract

Objective: Our aim was to investigate the value of neu­trophil/lymphocyte ratio for the diagnosis of acute appen­dicitis, and for the prediction of gangrenous/perforated appendicitis. Methods: The medical records of 162 patients having undergone appendectomies between January 2013 and September 2014 including age, gender, preoperatively as­sessed C-reactive protein (CRP), white blood cell (WBC), neutrophil (NEU), lymphocyte, and neutrophil/lymphocyte ratio (NLR) values were retrospectively evaluated, com­pared with the postoperative histopathological findings, and statistically analyzed. Results: The study group consisted of 97 (59.9%) men, and 65 (40.1%) women with a median age of 36.01 (18-90). Histopathological examinations revealed normal appendix in 21 (12.96%), and acute appendicitis in 141 (87.04%) patients. Appendiceal gangrene/perforation rate was 25.31%. Lymphocyte counts were decreased, while CRP, WBC, NEU, and NLR values were increased in acute appendicitis (p<0.05). NLR ≥4.0 was associated with 16.9 times increased possibility of acute appendicitis [p<0.01, Odds ratio (OR):16.864, 95% Confidence inter­val (CI):4.696-60.568]. In cases with NLR≥4.5, it was de­tected that the risk of appendiceal gangrene/perforation was 3.2 times higher [p<0.01, OR:3.258, 95% CI: 1.468-7.228]. Conclusions: In addition to physical examination and other diagnostic methods, NLR can be considered as a useful auxiliary tool for the diagnosis of acute appendi­citis, and for the prediction of gangrenous/perforated ap­pendicitis.

Keywords

Neutophil/lymphocyte ratio, acute appendicitis, apendiceal gangrene/perforation

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