Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 13 3 2025 08 01 The Diagnostic Value of Systemic Inflammatory Markers in Acute Appendicitis 47 54 118595 10.30483/rijm.2025.254604.1389 EN Mohammadreza Taheri Innovative Medical Research Center, MMS.C., Islamic Azad University, Mashhad, Iran 0000-0002-8682-3678 Amin Dalili Surgical Oncology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 0000-0001-6695-8551 Yalda Ravanshad Department of Community Medicine, MMS.C., Islamic Azad University, Mashhad, Iran Mojtaba Meshkat Department of Community Medicine, MMS.C., Islamic Azad University, Mashhad, Iran 0000-0003-0507-3295 Yeganeh Azadmanesh Department of Emergency Medicine, Razavi Hospital, Mashhad, Iran 0000-0003-1494-4718 Tooraj Zandbaf Department of General Surgery, MMS.C., Islamic Azad University, Mashhad, Iran 0000-0002-4882-5058 Journal Article 2025 01 15 <strong>Background: </strong>Early diagnosis of Acute Appendicitis (AA)can be challenging because it relies on the patient's signs and symptoms, which often mimic other abdominal pathologies.<br /><br /><strong>Objectives:</strong> The study aimed to assess the importance of systemic inflammatory response parameters in contrast with the Alvarado scoring system.<br /> <br /><strong>Methods: </strong>This cross-sectional study was conducted on 300 patients diagnosed with AA who underwent an appendectomy. Demographic data, medical history, physical examination findings, Alvarado score, complete blood count (CBC), and pathology results of the appendix were documented.<br /> <br /><strong>Results:</strong> In a study involving 300 patients, 53.7% were male. The mean age of the patients was 37.24 ± 14.79 years. The number of females with a negative appendectomy was 2.45 times higher than that of males. Most patients with appendicitis were male, while most with RLH (reactive lymphoid hyperplasia) and normal appendices were female. For diagnosing AA, the following thresholds were established: NLR (neutrophil-to-lymphocyte ratio) >2.93 with 90.08% sensitivity and 76.32% specificity, PLR (platelet-to-lymphocyte ratio) >117.8 with 70.61% sensitivity and 65.79% specificity. The sensitivity of the Alvarado scoring system was 79.8%, and its specificity was 81.6% at >6 cut-off value.<br /> <br /><strong>Conclusion:</strong> NLR, PLR, CRP (C-reactive protein), SII (systemic immune inflammation index), and Alvarado scoring showed great potential in diagnosing appendicitis with acceptable sensitivity and specificity. https://journal.razavihospital.ir/article_118595_48b9ef5bcb5ede1575779d29b9eeffe7.pdf