Índice neutrófilo-linfocito como marcador inflamatorio de predicción de la gravedad de apendicitis aguda
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Date
2024-02-08
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Universidad Nacional de Trujillo
Abstract
La apendicitis aguda (AA) es una de las emergencias quirúrgicas más frecuentes. Su diagnóstico precoz es un desafío, sobre todo el del tipo complicado; asociado con altas tasas de morbimortalidad. Ante ello, es imperioso encontrar un marcador capaz de discriminar correctamente la gravedad de AA durante el tiempo preoperatorio y que posea aceptable
exactitud diagnóstica. El índice neutrófilo-linfocito (INL) se perfila como un parámetro útil, accesible y económico para esta finalidad.
Objetivo: Determinar si el INL con valor >8.8 es un marcador inflamatorio de predicción de la gravedad de apendicitis aguda.
Material y métodos: Estudio observacional, analítico, retrospectivo y transversal de pruebas diagnósticas. Se incluyeron 510 historias clínicas de pacientes del Hospital Belén de Trujillo durante el año 2021, sometidos a apendicectomía y con confirmación por estudio histopatológico.
Resultados: El INL >8,8 presentó sensibilidad, especificidad, exactitud diagnóstica, VPP, VPN, Odds ratio, RVP y RVN de 90.55%, 87.91%, 89.61%, 93.10%, 83.77%, 69.68%, 7.49 y 0.11; respectivamente. El nuevo punto de corte de INL fue ≥8,68; con sensibilidad, especificidad y AUC de 90.85%, 87.91% y 0.919; respectivamente.
Conclusión: El INL >8,8 es un marcador inflamatorio estadísticamente significativo para predecir la gravedad de apendicitis aguda presentando índices clínicos aceptables.
Abstract Acute appendicitis (AA) is one of the most frequent surgical emergencies. Early diagnosis is a challenge, especially the complicated type; associated with high morbidity and mortality rates. In view of this, it is imperative to find a marker capable of correctly discriminating the severity of AA during the preoperative period and that has acceptable diagnostic accuracy. The neutrophil-to-lymphocyte ratio (NLR) is emerging as a useful, accessible and inexpensive parameter for this purpose. Objective: To determine whether the NLR value >8.8 is an inflammatory marker predicting the severity of acute appendicitis. Material and methods: Observational, analytical, retrospective and cross-sectional study of diagnostic tests. A total of 510 medical records of patients at the Hospital Belen in Trujillo during 2021, who underwent appendectomy and were confirmed by histopathological study, were included. Results: The NLR >8.8 showed sensitivity, specificity, diagnostic accuracy, PPV, NPV, odds ratio, PLR and NLR of 90.55%, 87.91%, 89.61%, 93.10%, 83.77%, 69.68%, 7.49 and 0.11; respectively. The new INL cut-off point was ≥8.68; with sensitivity, specificity and AUC of 90.85%, 87.91% and 0.919; respectively. Conclusion: The NLR >8.8 is a statistically significant inflammatory marker to predict the severity of acute appendicitis, presenting acceptable clinical indices.
Abstract Acute appendicitis (AA) is one of the most frequent surgical emergencies. Early diagnosis is a challenge, especially the complicated type; associated with high morbidity and mortality rates. In view of this, it is imperative to find a marker capable of correctly discriminating the severity of AA during the preoperative period and that has acceptable diagnostic accuracy. The neutrophil-to-lymphocyte ratio (NLR) is emerging as a useful, accessible and inexpensive parameter for this purpose. Objective: To determine whether the NLR value >8.8 is an inflammatory marker predicting the severity of acute appendicitis. Material and methods: Observational, analytical, retrospective and cross-sectional study of diagnostic tests. A total of 510 medical records of patients at the Hospital Belen in Trujillo during 2021, who underwent appendectomy and were confirmed by histopathological study, were included. Results: The NLR >8.8 showed sensitivity, specificity, diagnostic accuracy, PPV, NPV, odds ratio, PLR and NLR of 90.55%, 87.91%, 89.61%, 93.10%, 83.77%, 69.68%, 7.49 and 0.11; respectively. The new INL cut-off point was ≥8.68; with sensitivity, specificity and AUC of 90.85%, 87.91% and 0.919; respectively. Conclusion: The NLR >8.8 is a statistically significant inflammatory marker to predict the severity of acute appendicitis, presenting acceptable clinical indices.
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Keywords
Apendicitis, Ìndice neutrófilo-linfocito, Neutrófilos, Linfocitos, Sensibilidad y Especificidad, Curva ROC