Validez del índice neutrófilos - linfocitos como predictor de gravedad en pacientes mayores de 18 años diagnosticados de apendicitis aguda en el Hospital Vicente Corral Moscoso. Cuenca, 2020

Abstract

Background: acute appendicitis is the most frequent cause of acute emergency surgical abdomen worldwide. Although the usual clinical presentation is abdominal pain, in patients with atypical presentation the support of complementary studies is required, and the determination of the Neutrophil-Lymphocyte Ratio (NLI) is becoming a new predictive marker of severity.

Objective: to determine the acute validity of the NLR as an indicator of severity in patients over 18 years of age with Appendicitis.

Methodology: quantitative, observational study to validate the diagnostic test; approved by the Bioethics Committee. 144 patients older than 18 years admitted to the General Surgery Emergency with acute appendicitis were included. The sample size was calculated with a sensitivity of 70%, specificity of 48%, prevalence of Complicated Appendicitis 30%, power of 80%, confidence level of 95%. Data analysis and comparison was carried out in SPSS and Epidat.

Results: 59.7% of patients were between 18 to 34 years old with an average of 33 years (± 13 years); 50.7% were men. In addition, a total of 54.9% presented complicated acute appendicitis and it was determined that with an NLR ≥ 5.76, there is a sensitivity of 93.5% and a specificity of 43.4% to predict complicated acute appendicitis.

Conclusion: the NLR is a promising tool, since it undoubtedly has a high sensitivity to predict the severity of acute appendicitis, taking the histopathology result as the gold standard, however, with a low specificity in diagnostic precision.