Role of neutrophil lymphocyte ratio and platelet lymphocyte ratio as a predictive factor for severity of acute appendicitis.

Background: Acute appendicitis (AA) is a prevalent disease worldwide. Delay in diagnosis or management could resultin complications up to mortality. Timely management is the key to optimal outcomes. The neutrophil lymphocyte ratio(NLR) provides information regarding immune and inflammatory pathways, which makes it a potential marker to predictappendicitis and its severity. Also, changes in platelet lymphocyte ratio (PLR) may be a useful indicator of acute infection,including acute appendicitis.Objective: To determine whether NLR and PLR can predict the severity of acute appendicitis.Patients and Methods: This study is a diagnostic test evaluation study carried out in the department of general surgery intwo tertiary hospitals from November 2020 to July 2023. The study has two groups of patients, complicated appendicitis,and uncomplicated appendicitis, who underwent appendectomy and included 115 patients.Results: A normal appendix is diagnosed when NLR less than 3.5 and PLR less than 125, uncomplicated catarrhalappendicitis is diagnosed when NLR ranges from 3.5 to 5.8 and PLR ranges from 125 to 175, complicated phlegmonousappendicitis is diagnosed when NLR ranged from greater than 5.8 to 8.2 and PLR ranged from greater than 175 to 220,complicated gangrenous appendicitis is diagnosed when NLR greater than 8.2 and PLR greater than 220, with acceptablesensitivity and specificity P value (P <0.005).Conclusion: NLR and PLR are considered promising markers that can predict both diagnosis and severity of acuteappendicitis with acceptable sensitivity and specificity.