NEUTROPHIL-TO-LYMPHOCYTE RATIO INDEX AND PLATELET-TO-LYMPHOCYTE RATIO INDEX AS A PRECOCIOUS INDICATOR IN PROGRESSIVE AND NON PROGRESSIVE APPENDICULAR INFLAMMATION

Abstract

Overview :Appendicular Inflammation is easily the most easy to miss progressive medical emergencies that needs the utmost attention. Early differentiation is trivial for speedy and effective clinical decision-making.  NLR index and  PLR index have emerged as precocious indicators to study various diseases especially appendicular inflammation. This investigation focuses on this aspect.

Study Protocol: A Hospital record based study was conducted on 100 patients (n-100) aged 5-60 yrs who underwent operation. Statistical correlation was done based on the data obtained.

Results: Appendicular inflammation is more profound among young to middle-aged adults, particularly those aged 21–40 years, with comparable mean ages between groups (28.2 ± 10.1 vs. 26.5 ± 11.3 years, p = 0.58). Progressive cases showed higher leukocyte and platelet counts, pronounced neutrophil values, and lymphocyte values, indicating systemic inflammation. NLR >4.5 (OR: 4.32, p < 0.001) and PLR >210 (OR: 3.75, p = 0.002) were deemed as strong independent predictors of disease progression.

Inflammatory markers were significantly increased in progressive cases: CRP (42 ± 8 vs. 22 ± 6 mg/L, p < 0.001), procalcitonin (0.75 ± 0.12 vs. 0.35 ± 0.09 ng/mL, p < 0.001), serum bilirubin (1.5 ± 0.3 vs. 0.9 ± 0.2 mg/dL, p = 0.004), and ESR (26 ± 4 vs. 15 ± 3 mm/hr, p < 0.001).

Conclusion: NLR and PLR index serve as useful adjuncts for distinguishing between simple and complicated appendicular inflammation. Their inclusion into routine clinical procedure for prognosis and diagnosis can help in minimizing surgical intervention.