A novel combined neutrophil-platelet score for diagnosing complicated appendicitis: a retrospective and prospective cohort study.

PURPOSE: We investigated the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) and combined them to create an inflammatory marker, the combined neutrophil-platelet score (CNPS), to serve as a diagnostic and predictive tool for complicated appendicitis.

METHODS

A retrospective analysis was conducted on the clinicopathological data of patients who underwent appendectomy. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to evaluate the diagnostic performance of various inflammatory parameters. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for complicated appendicitis. A prospective study was then carried out to validate the clinical utility of the CNPS.

RESULTS

In total, 322 patients were included in the retrospective analysis. Multivariate analysis identified only onset time and NLR as independent risk factors for complicated appendicitis, whereas the PLR was not. CNPS demonstrated superior diagnostic and predictive performance for complicated appendicitis compared to NLR and PLR. Moreover, after adjusting for confounders, CNPS remained an independent risk factor for complicated appendicitis. In the prospective study, 264 patients were included for analysis, and the AUC of CNPS for predicting complicated appendicitis was 0.707.

CONCLUSION

The CNPS, combining NLR and PLR, demonstrates high diagnostic and predictive value for complicated appendicitis.