Association between complete blood count parameters and histologically proven acute appendicitis

The objective of the study was to assess the role of complete blood count (CBC) parameters in the detection of acute appendicitis (AA) severity in children and adults.

This is a retrospective analytic cross-sectional study on cases operated for AA between June 1, 2020, and February 28, 2021, in Salmaniya Medical Complex, Bahrain. Patients of all ages and genders were included in the study. Exclusion criteria included other appendiceal pathologies, the presence of another intraoperative pathology that is the likely cause of abdominal pain, normal appendix, and missing parameters. Data included patient demographics, CBC parameters, and histopathology. Patients were divided into groups based on age and severity of AA.

A total of 569 patients were included in the study. Ages ranged from 4 to 75 years. Majority of the patients were males (74.87%) and adults (89.81%). A quarter of the patients were diagnosed with complicated AA, while the rest had simple AA. A statistically significant difference was observed between adults with complicated and simple AA in white blood cell (WBC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). None of the parameters was statistically significant in children.

WBC, ANC, ALC, NLR, and PLR can be useful parameters in the discrimination between complicated and simple AA in adults. PLR was found to be the least predictive.