eutrophil Lymphocyte Ratio as A Predictive Factor of Complicated and Uncomplicated Acute Appendicitis

Background: Acute appendicitis is a common surgical emergency, but diagnosis remains challenging due to its similarity to other conditions. Several studies have used inflammatory biomarkers to diagnose acute appendicitis. One such biomarker is the neutrophil-lymphocyte ratio, which has demonstrated high accuracy in diagnosing appendicitis. The neutrophil-lymphocyte ratio is a simple comparison of the differential count of neutrophils and lymphocytes from peripheral blood tests. Methods: This study used an analytical observational diagnostic test using a retrospective cross-sectional study to determine the sensitivity and specificity of the neutrophil-lymphocyte ratio examination in cases of complicated appendicitis and uncomplicated appendicitis. Result: 65 patients were involved in this study. In this study, the Area Under Curve (AUC) was obtained at 0.89 with a Confidence Interval (95% CI = 0.81-0.97). The RNL cut-off point for complicated appendicitis > 6.8350 has a sensitivity of 81.81% and a specificity of 84.37%, a positive predictive value of 84.37% and a negative predictive value of 81.81%, a positive likelihood ratio of 5.2 and a negative likelihood ratio of 0.21. Conclusions: Studies on the neutrophil-lymphocyte ratio found that the sensitivity and specificity of the NLR examination in differentiating complicated appendicitis were excellent; this test can be easily performed in regional hospitals with limited facilities and resources.