Predicting Acute Appendicitis in Pregnant Patients Using the Neutrophil-to-Lymphocyte Ratio: A Meta-Analysis

To determine whether the neutrophil-to-lymphocyte ratio (NLR) can serve as a predictive indicator for acute appendicitis among pregnant females. A comprehensive search was conducted across multiple databases including PubMed, Embase, and Web of Science seeking to gather pertinent research on the NLR concerning pregnant individuals either suspected of or diagnosed with acute appendicitis. The NLR value and receiver operating characteristic (ROC) curve were utilized to assess the predictive value of the NLR in predicting acute appendicitis among pregnant patients. Seven studies and 410 patients were included in the meta-analysis. The area under the curve (AUC) for identifying acute appendicitis in pregnant patients using the NLR was found to be 0.856 (95% confidence interval [CI], 0.833-0.879). Additionally, the NLR values for pregnant patients with acute appendicitis were significantly elevated, showing a mean difference (MD) of 0.80 (95% CI, 0.58-1.03; p < 0.001). The NLR can be considered a valuable and effective diagnostic tool for anticipating acute appendicitis in pregnant patients.