Comparison of Platelet Distribution width and Total Leucocyte Count in Diagnosis of Acute Appendicitis: A Retrospective Study

INTRODUCTIONS Platelet distribution width (PDW) is a marker of platelet activation. Total leucocyte count (TLC) and platelet distribution width (PDW) are present in the complete blood cell count, which is routinely used in emergency department. PDW is an indicator of variation in platelet size, which can be a sign of active platelet release. Normal range of (PDW) is 9.017.0 fl. Normal range of total leucocyte count is 4000-11000 cells/mm3 in our laboratory. Recent studies have shown association of total leucocyte count and PDW in diagnosing acute appendicitis. This study aims at investigating the accuracy of PDW in Acute Appendicitis and also compare it with Total leucocyte counts. MATERIALS AND METHODS This is a retrospective study. All Patients presenting with right iliac fossa pain and suspected to have appendicitis admitted and operated at Justice K S Hegde Charitable Hospital, Mangalore were considered. A total of 130 patients were included in this study. The study looked into patients admitted and operated from January 2015 to February 2017. Patients between age group of 10 and 70 years were included in the study. Data analysis was done by calculating the mean, standard deviation, sensitivity, specificity, positive predictive value and negative predictive value. RESULTS In this study total leucocyte count and PDW of 130 patients were evaluated. The mean cut off score for TOTAL LEUCOCYTE COUNT was 10011 cells/mm3 and for PDW was 15.4 fl. A confidence interval of 95 % was considered. We found that TLC has a sensitivity of 80.7 %, specificity 61.38 %, PPV of 63.89 % and Negative predictive value (NPV) of 81.03 % in our study. It was also found that PDW has a sensitivity of 59.62 %, specificity 64.54 %, PPV of 86.11 % and NPV of 27.59 %. The specificity and PPV of PDW (64.54 %and 86.11 %respectively) was found to be better when compared to specificity and PPV of TLC (61.38 %and63.89 %). CONCLUSION The ability of platelet distribution width to confirm acute appendicitis was found to be better than total leucocyte count, while Total leucocyte count alone was specific to rule out non-acute appendicitis. Thus we conclude elevated platelet distribution width can be used as a marker for diagnosing acute appendicitis.