Clinical value of leukocyte counts in evaluation of patients with suspected appendicitis in emergency department

BACKGROUND The objective of this study was to assess the value of total leukocyte count in patients presenting to the emergency department with sign and symptoms suggestive of acute appendicitis. METHODS Patient demographics, presenting sign, and symptoms, initials total leukocyte count and discharge diagnosis was documented retrospectively. Admitted patients were followed for surgical and clinical outcomes, and discharged patients followed up by telephonic interview. RESULTS Out of 116 eligible patients 48 patients was found to have acute appendicitis. Total leukocyte count >= 10.000 cell/mm(3) yielded a sensitivity of 89.58% and a specificity of 64.71%. The positive predictive value (PPV) was 64.18%, and the negative predictive value (NPV) was 89.80%.The positive likelihood ratio (+LR) was 2.54, and the negative likelihood ration (-LR) was 0.16. The area under the curve for the receiver operating characteristic (ROC) curve was 0.822, which was moderately accurate. CONCLUSION The total leukocyte counts are helpful in the diagnosis and exclusion of acute appendicitis. The elevated leukocyte count >= 10,000 cells/mm(3) was statistically associated with the presence of acute appendicitis. The ROC curve suggests there is value of total leukocyte counts and has sufficient sensitivity and specificity to be clinical value in the diagnosis of acute appendicitis.