Clinical value of total white blood cells and neutrophil counts in patients with suspected appendicitis: retrospective study

World Journal of Emergency Surgery

Zuhoor K Al-gaithy¹ 

[1] Department of Surgery, King Abdulaziz University, P.O. Box 80215, Jeddah, 21589, Saudi Arabia

关键词: Receiver operating characteristic curves;    Neutrophil count;    Histological diagnosis;    White blood cells;    Diagnosis;    Acute appendicitis;   

Others  :  792182
DOI  :  10.1186/1749-7922-7-32

 received in 2012-07-20, accepted in 2012-09-03,  发布年份 2012

【 摘 要 】

Introduction

Acute appendicitis (AA) is common surgical problem associated with acute-phase reaction. Blood tests role in decision-making process is unclear. This retrospective study aimed to determine diagnostic value of preoperative evaluation of white blood cells (WBCs) and neutrophils and its value in predicting AA severity.

Methods

Medical records of 456 patients who underwent appendectomy during 4-years period were retrospectively reviewed. Patients were subdivided according to histological finding into: normal appendix (n = 29), uncomplicated inflamed appendix (n = 350), complicated appendicitis (n = 77). Diagnostic performances of WBCs and neutrophils were analyzed using receiver operating characteristic (ROC) curves.

Results

WBCs and neutrophils counts were higher in patients with inflamed and complicated appendix than normal appendix and in complicated than inflamed appendix. In patients, WBCs count 9.400 × 10³/mL had sensitivity of 76.81%, specificity of 65.52%, positive predictive value (PPV) of 97.0%, negative predictive value (NPV) of 16.1%, positive likelihood ratio [LR(+)] of 2.23, negative LR(−) of 0.35. Neutrophil count 7.540 × 10³/mL had sensitivity of 70.96%, specificity of 65.52%, PPV of 96.8%, NPV of 13.3%, LR(+) of 2.06, LR(−) of 0.44. Areas under ROC curve were 0.701, 0.680 for elevated WBCs and neutrophils count.

Conclusions

Clinicians should not rely on either elevated WBCs or neutrophils count as appendicitis indicator as clinical data are superior in decision-making appendectomy.

【 授权许可】

   
2012 Al-gaithy; licensee BioMed Central Ltd.

【 图 表 】

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