Evaluación de la utilidad del Índice Neutrófilo/Linfocito (INL) versus la Proteína C reactiva (PCR) como predictor de severidad de la Apendicitis aguda (AA) de acuerdo a los hallazgos intraoperatorios en pacientes pediátricos en el hospital de niños Dr. Roberto Gilbert E.

Abstract

Introduction: Acute appendicitis (AA) is the most frequent abdominal surgical pathology in the pediatric age, it presents a non-specific and varied clinical picture depending on the age of presentation. Objective: Demonstrate the utility of neutrophil/lymphocyte ratio (NLR) as an inflammatory marker of severity in AA compared to C-protein reactive (CRP). Methodology: An observational, prospective, cross-sectional, analytical study was conducted at the Dr. Roberto Gilbert E. Children's Hospital from June 1, 2020 to May 31, 2021. Pediatric patients with acute appendicitis were included, with a report of blood count and CRP. A file was recorded with variables such as age, sex, clinical manifestations and laboratory results. The data was stored and analyzed in Microsoft Excel, applying measures of frequency, percentage, Chi-Square test and ROC Curve. Results: The NLR presented a sensitivity to detect if the patient has complicated AA in 78% versus 30% of the CRP, in addition a specificity of 42% compared to the CRP in 91%, which indicates that the CRP is more effective to determine patients with uncomplicated AA. The NLR presented a positive predictive value of 52.3% and a negative predictive value of 70.34% compared to CRP, which obtained 75.38% and 61.98% respectively, demonstrating that CRP has a 70.34% probability of detecting a complicated AA. Conclusion: Both CRP and NLR are acute phase inflammatory markers that help to evaluate the severity of AA.