Predictive Efficacy of Delta Neutrophil Index in Diagnosis of Acute and Complicated Appendicitis

Background The delta neutrophil index has been accepted as an inflammatory marker, especially in sepsis. This study aimed to evaluate the effectiveness of the delta neutrophil index in predicting acute and complicated appendicitis. Methods Patients aged 18 years and over who underwent appendectomy were reviewed. The demographic features, pathology results, and the delta neutrophil index, leukocyte, and C-reactive protein levels were evaluated. According to the pathology results, the patients were grouped as those having a normal appendix or acute appendicitis. Results In this study, 74 (8.1%) of the patients had a normal appendix, and 718 (86.1%) were diagnosed with simple appendicitis, and 116 (13.9%) with complicated appendicitis. In the acute appendicitis group, the leukocyte value and delta neutrophil index were found to be statistically significantly higher than in the normal appendix group. Age, C-reactive protein, and the delta neutrophil index ​​were statistically significantly higher in the complicated appendicitis group. In the receiver operating characteristic curve analysis for the prediction of acute appendicitis, the area under the curve values for leukocyte and the delta neutrophil index were calculated as 0.780 and 0.741, respectively. In predicting complicated appendicitis, the area under the curve of the delta neutrophil index and C-reactive protein were 0.671 and 0.709, respectively. Conclusion The delta neutrophil index was more significant than leukocyte values in diagnosing acute and complicated appendicitis. We consider that the delta neutrophil index ​​is an effective and reliable parameter in diagnosing acute appendicitis and differentiating simple/complicated appendicitis, especially when combined with the analysis of leukocyte and C-reactive protein.