Platelet to Lymphocyte Ratio for Prioritising Perforated or Gangrenous Appendicitis in a Triage of an Emergency Room

Abstract

Aim: Some studies suggested Platelet Lymphocyte Ratio (PLR) is associated with perforated or gangrenous appendicitis. This study aimed to evaluate the effectiveness of the platelet-lymphocyte ratio in distinguishing simple acute appendicitis from perforated or gangrenous appendicitis in the clinical emergency setting Method: This study was conducted retrospectively in academic tertiary hospital on 302 patients who had undergone appendectomy for a period of eight years from mid of 2008 to the mid of 2016. We divided them according to their histopathological results two to groups simple acute appendicitis and perforated or gangrenous appendicitis. Results: The study demonstrated that PLR is a useful indicator in diagnosing perforated or gangrenous appendicitis with a cutoff value of 197.57 with sensitivity 63.3% and specificity 38.7% and P=0.057. The risk for developing perforated or gangrenous appendicitis in patients with high Platelet Lymphocyte Ratio (PLR) was 1.5 times higher than those with standard Platelet Lymphocyte Ratio odds ratio (OR): 1.58 (P=0.002). Conclusion: PLR is a simple, cost-effective is a useful parameter that diagnoses complicated perforated appendicitis.