PERFORMANCE OF THE NEUTROPHIL-TO-LYMPHOCYTE RATIO FOR PREDICTING COMPLICATED ACUTE APPENDICITIS IN ADULTS AND OLDER ADULTS AT A REFERRAL HOSPITAL IN LIMA, PERU

Temoche R.; Villanueva M.; Solari L. · Revista de la Facultad de Medicina Humana (2026) · DOI: 10.25176/rfmh.v26i3.8657

Resumen

Introduction: The neutrophil-to-lymphocyte ratio (NLR) has shown utility for predicting complicated acute appendicitis (CAA), although its performance may vary with age. Objective: To determine the diagnostic performance of the NLR for identifying CAA according to age group in patients treated at a referral emergency hospital in Lima, Peru. Methods: This retrospective study included 141 adult patients with a postoperative diagnosis of acute appendicitis between 2018 and 2024. NLR cut-off values of 8.8 and 6.0 were evaluated in the overall population and in patients younger than 65 years and those aged 65 years or older. Results: CAA was present in 70.9% of patients. The area under the curve (AUC) was 0.82, with a 95% confidence interval (95% CI) of 0.74–0.90 in the overall population, 0.86 (95% CI: 0.77–0.95) in patients younger than 65 years, and 0.78 (95% CI: 0.65–0.90) in patients aged 65 years or older, with no statistically significant differences between age groups (p = 0.290). At the 6.0 cut-off, sensitivity was 85%, specificity was 63.41%, and diagnostic accuracy was 78.72%. Conclusion: The NLR showed good diagnostic performance for predicting CAA, with no statistically significant differences between age groups. Of the two prespecified cut-off values, the 6.0 threshold showed higher sensitivity and diagnostic accuracy than the 8.8 threshold. The NLR could be used as a complementary tool for assessing severity in patients with confirmed appendicitis. © Artículo publicado por la Revista de la Facultad de Medicina Humana de la Universidad Ricardo Palma. Es un artículo de acceso abierto, distribuido bajo los términos de la Licencia Creative Commons: Creative Commons Attribution 4.0 International, CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/), que permite el uso no comercial, distribución y reproducción en cualquier medio, siempre que la obra original sea debidamente citada. Para uso comercial, por favor póngase en contacto con revista.medicina@urp.pe.

Instituciones: Universidad Peruana de Ciencias Aplicadas