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All Journal International Journal of Public Health Science (IJPHS) JBN (Jurnal Bedah Nasional)
Heriyanto, Moch Junaidy
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Health Professions Medicine & Pharmacology

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The Role of Neutrophil to Lymphocyte Ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) in Appendicitis Heriyanto, Moch Junaidy; Ratnaningsih, Tri; Heriyanto Putri, Rona Hafida; Fatimah, Bunga; Astuti, Fardhiasih Dwi
JBN (Jurnal Bedah Nasional) Vol 8 No 1 (2024): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JBN.2024.v08.i01.p01

Abstract

Aim: Predictive values of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with poor outcomes in several diseases. Furthermore, there has been limited publication of those parameters in appendicitis patients in Indonesia. This study aims to evaluate the role of NLR and PLR in differentiating complicated appendicitis and uncomplicated appendicitis. Methods: The design of this study is a retrospective using medical records of appendicitis patients from January 1, 2016, to December 31, 2020, conducted at PKU Muhammadiyah Bantul Hospital. There are 408 data on appendicitis patients that can be analyzed. Results: The WBC, neutrophils, NLR, and PLR was significantly higher in the complicated appendicitis group than in the uncomplicated group [11,5 (3.79-35.2) vs. 8.42 (3.32-39.30), p<0.0001; 8.63 (2.359-2.647) vs. 5.446 (1.691-35.960), p<0.0001; 5.65 (0.95-23.86) vs.3.82 (0.81-23.86), p<0.0001; 168.57 (37.27-974.03) vs.139.40 (56.84-1274.31), p<0.0001, respectively] followed by a significantly lower lymphocyte count [1.709 (0.154-5.71) vs. 2.094 (0.401-5.812), p<0.0001, respectively]. The area under the receiver operating characteristic (ROC) curve, cutoff point, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratio of NLR for diagnosis of complicated appendicitis were 0.76, >2.84, 75.21%, 62.65%, 74.6%, 63.4%, 2.01, 0.40, respectively. In contrast, an area under ROC curve, cutoff point, sensitivity, specificity, PPV, NPV, and likelihood ratio of PLR for differentiating complicated and uncomplicated appendicitis were 0.605, >140.6, 65.70%, 51.81%, 66.5%, 50.9%, 1.36, and 0.66 respectively. Conclusion: The cutoff values of NLR (>2.84) and PLR (>140.6) were significant diagnostic parameters for complicated appendicitis (p = 0.0001). Hence, NLR and PLR can assist in diagnosing complicated appendicitis.
Profile of appendicitis patient: epidemiology, clinical, and laboratories evaluation in rural-urban area Heriyanto, Moch Junaidy; Ratnaningsih, Tri; Fatimah, Bunga; Putri, Rona Hafida Heriyanto; Nisa, Afifah Khairu
International Journal of Public Health Science (IJPHS) Vol 12, No 4: December 2023
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v12i4.22986

Abstract

Appendicitis is one of the most common abdominal inflammations in daily emergency cases. The diagnosis of appendicitis is often delayed because the symptoms resemble other abdominal emergencies. The present research aimed to describe the clinical and epidemiological profile of acute appendicitis patients. The research design is a cohort retrospective study employing appendicitis patients' medical record data at PKU Muhammadiyah Hospital from January 1, 2016, to December 31, 2020. The variables obtained through the patient records were age, gender, domicile location, vital signs, physical examination, blood laboratory, ultrasound, histopathology, postoperative diagnosis, the incidence of peritonitis, and length of stay. The median age value in patients with appendicitis was 27 years (0-95), and the largest group was young adults (19-44 years). Abdominal pain was found in almost all research subjects. The median of leukocytes was 10.1 (3.32-65.80)×106/ml and the neutrophil-lymphocyte ratio (NLR) was 3.52 (0.47-30.57)/μl. The median percentage of the neutrophil count was 70.7 (27.90-94.81). The final diagnosis of complicated appendicitis was more than uncomplicated appendicitis (51.2% vs. 48.8%). We conclude that several detailed parameters, such as the location of abdominal pain, leukocyte count, and NLR can help the physician diagnose appendicitis and guide surgeons in deciding the type of surgery.
Co-Authors Fardhiasih Dwi Astuti Fatimah, Bunga Heriyanto Putri, Rona Hafida Nisa, Afifah Khairu Putri, Rona Hafida Heriyanto Tri Ratnaningsih