• Serkan Sengul, Yilmaz Guler, Hasan Calis, and Zulfikar Karabulut.
• Department of General Surgery, Alanya Alaaddin Keykubat University, Alanya, Antalya, Turkey.
• J Coll Physicians Surg Pak. 2020 Apr 1; 30 (4): 420-424.

ObjectiveTo investigate if serum biomarkers could differentiate complicated and uncomplicated appendicitis in adolescents.Study DesignAn cross sectional study.Place And Duration Of StudyDepartment of General Surgery, Faculty of Medicine, Alanya Alaaddin Keykubat University, Alanya, Turkey, between January 2016 and December 2018.MethodologyPatients operated for acute appendicitis, aged between 10 and 19 years, were retrospectively evaluated. Patients were divided according to the negative appendectomy (group 1), uncomplicated appendicitis (group 2A) and complicated appendicitis (group 2B). White blood cell count (WBC), neutrophil count (NEU), lymphocyte count (LC), neutrophil/lymphocyte ratio (NLR), mean platelet volume (MPV), red cell distributions width (RDW), C-reactive protein (CRP), and length of hospital stay (LoHS) were analysed by ROC curve, one-way and Mann-Whitney U-tests.ResultsThere were 277 adolescents (group 1=30, group 2A=205 and group 2B=42). There were statistically significant differences between the groups in WBC, NEU, LYM, NLR, CRP, LoHS. The cut-off values of NLR, WBC, and NEU were 4.1, 10.6x109/L, and 8.17x109/L, respectively for uncomplicated appendicitis, and 7.32, 11.5x109/L, and 10.3x109/L, respectively for complicated appendicitis. The cut off value of CRP was 1.3 mg/dl for complicated appendicitis.ConclusionsElevated WBC, NEU, CRP and NLR may be considered useful biomarkers in assisting physical examination and other diagnostic methods in distinguishing severity of acute appendicitis. Key Words: Adolescent, Appendicitis, Neutrophil-to-lymphocyte ratio, C-reactive protein, Length of hospital stay.

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