ArticleUlusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES2026
The role of the C-reactive protein to lymphocyte ratio in the diagnosis of complicated acute appendicitis.
Article in Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Association Between C-Reactive Protein-to-Albumin Ratio and Length of Hospital Stay in Elderly Patients with Acute Appendicitis: A Mediation Analysis of Complicated Appendicitis.Clinical interventions in aging · 2026Article
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9 authors.
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Abstract
backgroundTo assess the diagnostic value of the C-reactive protein to lymphocyte ratio (CLR) and other inflammatory markers in distinguishing complicated from uncomplicated acute appendicitis (AA) to support timely surgical intervention.
methodsThis retrospective study included 682 patients who underwent appendectomy between January 2018 and January 2021. Based on the histopathological American Association for the Surgery of Trauma (AAST) AA grading system, patients were classified as complicated AA (grades 3-5; n=144) or uncomplicated AA (grades 1-2; n=538). Preoperative laboratory values-white blood cell (WBC) count, neutrophil count, C-reactive protein (CRP), sodium (Na), CLR, neutrophil-to-lymphocyte ratio (NLR), and CRP/Na-were analyzed. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis.
resultsComplicated AA cases were significantly older (37.5+-17.6 vs. 30.0+-12.8 years; p<0.001). CRP (7.17+-6.78 vs. 2.98+-4.52 mg/dL), WBC, neutrophils, and CLR (5.66+-9.13 vs. 1.89+-3.94) were significantly elevated in the complicated group (p<0.001). CLR showed moderate diagnostic accuracy (AUC=0.712), with a cutoff of ≥2.82 yielding 53.5% sensitivity and 82.7% specificity (OR=5.49, 95% CI: 3.69-8.16). Hyponatremia and elevated NLR/PLR also correlated with complications.
conclusionCLR is a moderately accurate, highly specific, and accessible biomarker for identifying complicated AA. Its integration with clinical evaluation may enhance preoperative risk stratification, especially in resource-limited settings.
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