Diagnostic Value of Total and Differential Leukocyte Counts for the Diagnosis of Acute Appendicitis

Abstract

Patients presenting with acute appendicitis may have a clear clinical diagnosis; unusual presentations might cause diagnostic confusion and therapeutic delays. The purpose is to establish the predictive value of total and differential leukocyte counts for the acute appendicitis diagnosis.

OBJECTIVE AND METHODOLOGY: This cross-sectional study lasted for 6 months over 95 patients. In order to determine TLC and DLC, a blood sample was taken. The patients were categorized as TLC positive or negative & DLC positive or negative. Appendectomy was performed to determine whether the patient was positive or negative. TLC and DLC's sensitivity, specificity, PPV, NPV, and diagnostic accuracy were calculated & outcomes mentioned.

RESULTS: Patients had mean age of 31.20±12.14 years. A total of 60 women (63.2%) and 35 men (36.8%). Patients' mean body mass index was 23.394.87kg/m2. We calculated a mean time to resolution of 6.603.53 hours. TLC averaged 13413.12 ±8142.58 per milliliter. Overall, the DLC averaged 76.33 ±12.56%. TLC had a Sensitivity of 90.7%, Specificity of 96.2%, PPV of 95.1%, NPV of 92.6%, and Diagnostic Accuracy of 93.7% to diagnose acute appendicitis. For DLC, Diagnostic accuracy was 88.4%, sensitivity 88.4%, specificity 76.9%, PPV 76%, NPV 88.9% & PPV of 76% for identifying acute appendicitis.

CONCLUSION: In an emergency setting both TLC and DLC were reliable enough allowing the patients to have some confirmation that they were experiencing the signs of acute appendicitis and avoiding an appendectomy or unneeded surgery in at least the negative cases.