Erdenetsetseg Chuluun^1,2, Bayartsetseg Ankhbayar¹, Ganbayar Ganzorig², Ganbayar Luuzan³, Davaalkham Dambadarjaa⁴, Zorig Dungerdorj¹, Puntsag Chimedtseye¹

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¹ Department of Surgery, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
² Mongolian-Japan Teaching Hospital, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
³ Mongolian National Center for Maternal and Child Health, Ulaanbaatar, Mongolia.
⁴ School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
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Abstract: Introduction: Acute appendicitis (AA) is a common surgical disease which occurs in almost all age groups, and especially in childhood. Acute appendicitis is one of the most common causes of acute abdomen. The lifetime occurrence of this disease is approximately 7%, with perforation rate of up to 20%. In spite of the well-known classical symptoms and clinical findings of acute appendicitis, early diagnosis can be sometimes challenging. For the treatment of simple appendicitis (SA) in children, the effectiveness of antibiotic treatment has been reported. We aimed to determine predictive value of combination NLR and PAS in pediatric patients with clinical suspicion of acute appendicitis and complicated appendicitis Methods: Our study was performed on 480 children admitted for suspected acute appendicitis and underwent appendectomy at the MNCMCH, Ulaanbaatar Mongolia, between May 2019 and December 2019. White blood count (WBC), Neutrophil, NLR and PAS were compared between groups. Results: The sensitivity, specificity, PPV, NPV of PAS + NLR for differentiating complicated and noncomplicated appendicitis were 86.8%, 89.4%, 92.1% and 76% respectively. The sensitivity, specificity, PPV, NPV of PAS + NLR for diagnosis of acute appendicitis were 90.5%, 68.1%, 97.68% and 32.6% respectively. Conclusion: In the era of conservative antibiotic-based management of uncomplicated acute appendicitis, we advocate that combination of NLR and PAS is a useful aid in predicting complicated appendicitis.

Keywords: Acute Appendicitis, Complicated Appendicitis, Neutrophil to Lymphocyte Ratio, Antibiotic, Pediatric Patient

Cite this paper: Chuluun, E. , Ankhbayar, B. , Ganzorig, G. , Luuzan, G. , Dambadarjaa, D. , Dungerdorj, Z. and Chimedtseye, P. (2020) Usefulness of the Pediatric Appendicitis Score and Neutrophil to Lymphocyte Ratio for Assessing the Complicated Appendicitis in Children. Open Journal of Clinical Diagnostics, 10, 93-103. doi: 10.4236/ojcd.2020.104008.

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