Comparison of some parameters of white blood cell counts in accuracy for the diagnosis of pediatric acute appendicitis

Abstract

Background: Acute appendicitis is main causes of acute abdominal pain in pediatric practice. There are still controversial issues in diagnose of pediatric acute appendicitis and removel of normal appendices was reported. Objective: To investigate white blood cell counts and its some parameters in peripheral blood of Mongolian children with and without acute appendicitis. Materials and methods: Prospective case-controlled study was designed in two groups with and without acute appendicitis. The sensitivity and specificity for each outcome under study were plotted with Area under Curve (AUC), thus generating an ROC curve. P value less than 0.05 was considered statistically significant. Results: The study involved 480 children. Based on the changes of pathological examination tissue samples were classified as group nonappendicitis (119 cases) and with appendicitis (361 cases). There was no difference in age and gender between to two groups (p= 0.217 and 0.395). White blood cell (p<0.001), neutrophil count (p<0.001), lymphocyte count (p<0.001) and neutrophil to lymphocyte ratio (p<0.001) were different between the two groups. The result of area under curve according to receiver operating characteristics analysis were as follow : 0.614 for white blood cell count, 0.716 for neutrophil count, 0.217 for lymphocyte count, and 0.934 for neutrophil to lymphocyte ratio. With a cut-off value of 4.97 of neutrophil to lymphocyte ratio sensitivity and specificity were 89.4% and 83.3% respectively. Conclusion: Neutrophil-lymphocyte ratio shows a high accuracy for the diagnosis of pediatric acute appendicitis and distinguishing a complicated appendicitis from the simple one, than other biomarkers.