Background: Acute appendicitis (AA) is a prevalent disease worldwide. Delay in diagnosis or management could result
in complications up to mortality. Timely management is the key to optimal outcomes. The neutrophil lymphocyte ratio
(NLR) provides information regarding immune and inflammatory pathways, which makes it a potential marker to predict
appendicitis and its severity. Also, changes in platelet lymphocyte ratio (PLR) may be a useful indicator of acute infection,
including acute appendicitis.
Objective: To determine whether NLR and PLR can predict the severity of acute appendicitis.
Patients and Methods: This study is a diagnostic test evaluation study carried out in the department of general surgery in
two tertiary hospitals from November 2020 to July 2023. The study has two groups of patients, complicated appendicitis,
and uncomplicated appendicitis, who underwent appendectomy and included 115 patients.
Results: A normal appendix is diagnosed when NLR less than 3.5 and PLR less than 125, uncomplicated catarrhal
appendicitis is diagnosed when NLR ranges from 3.5 to 5.8 and PLR ranges from 125 to 175, complicated phlegmonous
appendicitis is diagnosed when NLR ranged from greater than 5.8 to 8.2 and PLR ranged from greater than 175 to 220,
complicated gangrenous appendicitis is diagnosed when NLR greater than 8.2 and PLR greater than 220, with acceptable
sensitivity and specificity P value (P <0.005).
Conclusion: NLR and PLR are considered promising markers that can predict both diagnosis and severity of acute
appendicitis with acceptable sensitivity and specificity.