Correlation of Leukocyte Count and Percentage of Segmented Neutrophils with Pathohistological Findings of Appendix in Children

Authors

1 Department of Pediatric Surgery, Children's Hospital Zagreb, Klaićeva 16, Zagreb 10000, Croatia.

2 Professor, Department of Pediatric Surgery, Children's Hospital Zagreb, Klaićeva 16, Zagreb 10000, Croatia.

3 University of Zagreb, School of Medicine, Šalata 3, Zagreb 10000, Croatia.

4 Assistant professor, Department of Pediatric Surgery, Children's Hospital Zagreb, Klaićeva 16, Zagreb 10000, Croatia.

5 Professor, Department of Histology and Embriology, University of Zagreb, School of Medicine, Šalata 3, Zagreb 10000, Croatia.

Abstract

Background
Appendicitis is the most common indication for an emergency operation in children's age. Although none of the laboratory values has not high sensitivity and specificity for the diagnosis of appendicitis, leukocyte count and the percentage of segmented neutrophils are most commonly used. The aim of this study was to determine whether there is a statistically significant correlation between leukocyte count and the percentage of segmented neutrophils compared to the pathohistological finding of appendix in children.

Materials and Methods
We retrospectively analyzed the data in the period from 1 January 2016 to 31 December 2016. The analysis was made on 211 patients. Spearman's correlation coefficient (rs) was calculated. We determined the specificity and sensitivity of leukocyte count and the percentage of segmented neutrophils used in the calculation of Alvorado and Pediatric Appendicitis score.

Results
The results of the research have shown that the correlation between leukocyte count and the pathohistological findings is weak (rs = 0.29, p = 3.61*10-8), while there is no correlation between the percentage of segmented neutrophils and pathohistological findings (rs = 0.18, p = 7.08 *10-5). The sensitivity of leukocyte count is 93% and the specificity is 30%, while the sensitivity to the percentage of segmented neutrophils is 71% and the specificity is 50%. ROC analysis for leukocytes shows area under the curve of 0.648, while for segmented neutrophils of 0.574.


Conclusion
Given the correlation results obtained, the clinical experience of physicians will still have one of the leading roles in diagnosing acute appendicitis in children.

Keywords