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Cirugía y cirujanos

versão On-line ISSN 2444-054Xversão impressa ISSN 0009-7411

Resumo

GODINEZ-VIDAL, Ansony R. et al. Comparison of the neutrophil-to-lymphocyte ratio, SOFA score and serum procalcitonin as biomarkers of acute appendicitis. Cir. cir. [online]. 2019, vol.87, n.1, pp.12-17.  Epub 29-Nov-2021. ISSN 2444-054X.  https://doi.org/10.24875/ciru.18000216.

Background:

Acute appendicitis (AA) is one of the main causes of acute abdomen that requires urgent surgical treatment, a delay in its diagnosis and therapeutic increase in morbidity and mortality.

Objective:

To evaluate the usefulness of inflammatory markers as a tool to compare the neutrophil/lymphocyte ratio (NLR), the SOFA scale (Sequential Organ Failure Assessment) and the serum level of procalcitonin, total bilirubin, and see if there is a relationship as indicators and determinants of the severity of AA.

Method:

An retrospective, observational, and analytical study to evaluate the usefulness of the NLR as a diagnostic and severity indicator of AA, comparing it against biomarkers (BT and PCT), and against two severity scales (APACHE II [Acute Physiology and Chronic Health Evaluation] and SOFA) and a surgical scale (Mannheim).

Results:

We included 82 cases from January to May 2017. 80.8% of those cases with generalized peritonitis had an NLR > 12 (p = 0.002). 66% of the cases with appendiceal perforation presented an NLR > 12 (p = 0.024). 70% of severe cases due to TB showed an NLR > 12 (p = 0.004). 75% of severe cases due to PCT have an NLR > 12 (p = 0.006). 50% of the cases with SOFA > 6 showed an NLR > 12 (U Mann-Whitney, p = 0.023).

Conclusions:

There is a relationship between the NLR with SOFA, total bilirubin and procalcitonin, indicating that an NLR > 12 points could be related to generalized peritonitis and perforated appendicitis.

Palavras-chave : Acute appendicitis; Neutrophil-to-lymphocyte ratio; Severity; Procalcitonin; SOFA.

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