E. B. Rodas1,2, M. Guillén2, E. Granda2, F. Martínez2, E. B. Rodas1,2 1Virginia Commonwealth University,Acute Care Surgical Services/ Surgery,Richmond, VA, USA 2Universidad Del Azuay,Cuenca, AZUAY, Ecuador
Introduction:
Neutrophil to lymphocyte ratio (NLR) has demonstrated to be a marker of inflammatory response in many conditions including acute appendicitis. We hypothesize that admission NLR could predict hospital length of stay (HLOS) in acute appendicitis.
Methods:
A retrospective cohort study was conducted during 2013 in a tertiary hospital and included all patients admitted through the emergency department with the diagnosis of acute appendicitis treated surgically. A database utilizing SPSS-V19 was created. To evaluate sensitivity of the test we constructed ROC curves; association between variables and risk was evaluated with chi-square and odds ratio.
Results:
During the 12-month period 338 patients were admitted with acute appendicitis. There were 203 (60.05%) male and 135 (39.94%) female patients. Mean age 34.67 ± 11.65 years. When chi-square was applied to increased NLR and HLOS a value of 21.36 (p <0,05), odds ratio 3.019 (CI 1.874-4.864). Also chi-square was applied to NLR and ICU admission, a value of 3.64 (p <0.05) and an odds ratio of 6,18 (CI 0.736 – 51.931). Moreover, the NLR for the different phases of appendicitis was: inflammatory phase (n=87), 7.98 (± 10.40), suppurative (n=142) 11.27 (± 23.54), gangrenous (n=67) 8.15 (± 4.78) and perforated (n=42) 18.44 (± 23.78).
Conclusion:
In acute appendicitis, a higher NLR is associated with an increased in HLOS. The utilization of this simple parameter could potentially be used to allocate resources at the time of admission. Furthermore, NLR trended upward as the disease severity progresses. Additional studies are warranted to validate these findings.
