Back to Search
Start Over
Clinical value of total white blood cells and neutrophil counts in patients with suspected appendicitis: retrospective study
- Source :
- World Journal of Emergency Surgery, Vol 7, Iss 1, p 32 (2012), World Journal of Emergency Surgery : WJES
- Publication Year :
- 2012
- Publisher :
- BMC, 2012.
-
Abstract
- 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.
- Subjects :
- medicine.medical_specialty
Pathology
Neutrophil count
lcsh:Surgery
Likelihood ratios in diagnostic testing
Gastroenterology
Internal medicine
Diagnosis
medicine
In patient
Acute appendicitis
Receiver operating characteristic
business.industry
lcsh:Medical emergencies. Critical care. Intensive care. First aid
Retrospective cohort study
lcsh:RD1-811
lcsh:RC86-88.9
Histological diagnosis
Appendix
medicine.anatomical_structure
Absolute neutrophil count
Emergency Medicine
White blood cells
Surgery
Suspected appendicitis
business
Receiver operating characteristic curves
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 17497922
- Volume :
- 7
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- World Journal of Emergency Surgery
- Accession number :
- edsair.doi.dedup.....1476380e6c1f4c5da295911d9a9f77d6