Total Leukocyte and Neutrophil count as preventive tools in reducing negative appendectomies

Abstract

BACKGROUND: Negative appendectomies result in unnecessary admissions, health care burden, and cost. This study was conducted to assess total leukocyte and neutrophil counts as preventive tools in reducing negative appendectomies. METHODS: Data of admitted patients who underwent appendectomies was analyzed. Receiver operator characteristic (ROC) curve analysis of total leukocyte and neutrophil counts was calculated for various cut-off points. Optimum sensitivity, specificity, overall accuracy, and area under the curve was determined. RESULTS: Of the four hundred and eightpatients, true and negative appendicitis by operative assessment was 294 (72.1%) and 114 (27.9%) compared to 311 (76.2%) and 97 (23.8%) by histopathology, respectively. Optimal cut-off for total leukocyte count was >11.9x10(9)/Liter with 87.14% sensitivity and 91.75% specificity. Optimal cut-off point for neutrophil count was >7.735x10(9)/Liter with 98.71% sensitivity and 91.75% specificity. Area under the curve for total leukocyte and neutrophil counts was 0.9603 and 0.9872, respectively with overall accuracy of 91.2% and 97.1%, respectively. CONCLUSION: Normal total leukocyte and neutrophil counts are strongly associated with negative appendectomies. Non-operative measures and careful observation of total leukocyte and neutrophil counts are of paramount importance.