Neutrophil to C-reactive protein ratio and lymphocyte to C-reactive protein ratio can be a predictor for severity of acute appendicitis

Background Acute appendicitis (AA) is one of the most common causes of acute abdomen. Mortality and morbidity rates increase in patients with AA from the simple group to the complicated group. In this study, the authors wanted to show the effectiveness of lymphocyte to C-reactive protein (CRP) ratio (LCR) and neutrophil to CRP ratio (NCR) in detecting complications in patients with AA. Patients and methods The study population was selected from patients who were admitted to the emergency department with abdominal pain between June 2019 and June 2021, and who were operated in the general surgery clinic with a preliminary diagnosis of AA. Demographic data such as age, sex, and laboratory results were recorded. The patients were histopathologically divided into two groups as simple appendicitis (SA) and complicated appendicitis (CA). Results A total of 778 patients met the inclusion criteria. The LCR and NCR levels of the patients were found to be significantly lower in the CA group compared with the SA group (0.11 +/- 0.31 vs. 0.44 +/- 1.07; 0.65 +/- 1.65 vs. 2.44 +/- 5.54, P<0.001, respectively). In regression analysis, LCR (odds ratio [OR] 0.380, 95% confidence interval [CI] 0.156-0.929, P=0.034) and NCR (OR 0.539, 95% CI 0.295-0.985, P=0.044) were independent predictors of complication. Conclusions Low LCR and NCR levels at the time of admission to the emergency department are a biomarker that can predict complications in patients with AA.