Background:

Acute appendicitis (AA) is one of the main causes of acute abdomen that requires urgent surgical treatment, a delay in its diagnosis and therapeutic increase in morbidity and mortality.

Objective:

To evaluate the usefulness of inflammatory markers as a tool to compare the neutrophil/lymphocyte ratio (NLR), the SOFA scale (Sequential Organ Failure Assessment) and the serum level of procalcitonin, total bilirubin, and see if there is a relationship as indicators and determinants of the severity of AA.

Method:

An retrospective, observational, and analytical study to evaluate the usefulness of the NLR as a diagnostic and severity indicator of AA, comparing it against biomarkers (BT and PCT), and against two severity scales (APACHE II [Acute Physiology and Chronic Health Evaluation] and SOFA) and a surgical scale (Mannheim).

Results:

We included 82 cases from January to May 2017. 80.8% of those cases with generalized peritonitis had an NLR > 12 (p = 0.002). 66% of the cases with appendiceal perforation presented an NLR > 12 (p = 0.024). 70% of severe cases due to TB showed an NLR > 12 (p = 0.004). 75% of severe cases due to PCT have an NLR > 12 (p = 0.006). 50% of the cases with SOFA > 6 showed an NLR > 12 (U Mann-Whitney, p = 0.023).

Conclusions:

There is a relationship between the NLR with SOFA, total bilirubin and procalcitonin, indicating that an NLR > 12 points could be related to generalized peritonitis and perforated appendicitis.