Evaluation of laboratory parameters in the diagnosis of acute appendicitis

Introduction: The aim of this prospective study was to investigate the diagnostic value of the fibrinogen level, platelet (PLT) count, mean platelet volume (MPV), lymphocyte count, neutrophil/lymphocyte ratio (NLR) and C-reactive protein (CRP) level with white blood cell (WBC) and neutrophil count in acute appendicitis (AA). Methods: One hundred and ninety-seven patients who were admitted with the findings of acute abdomen and operated on with a preoperative diagnosis of AA were included in this prospective observational study. After surgery, according to the histopathological results of the appendix, patients were classified as Group 1; with normal histology of appendix vermicularis, Group 2; patients with positive histology for appendicitis with or without perforation, periappendiceal abscess, suppurative, gangrenous or ulcerophlegmonous appendicitis. Results: In the comparison of the two groups, the difference between CRP and MPV were insignificant (p = 0.12 and p = 0.09, respectively). WBC, neutrophil count, NLR were significantly higher in Group 2 (p < 0.001 for each), whereas fibrinogen levels, lymphocyte count and the PLT counts were significantly higher in Group 1 (p = 0.03, 0.002 and 0.003, respectively). Discussion and conclusion: WBC, neutrophil and NLR are predictive for the diagnosis of AA, whereas elevated levels of fibrinogen, high lymphocyte and PLT count are predictive for non-appendicial pathology with low diagnostic accuracies.