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

Öz

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.

Anahtar Kelimeler

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

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

Öz

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.

Anahtar Kelimeler

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

Kaynakça

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