Background: Acute appendicitis continues to be a primary reason for emergency abdominal surgery worldwide. Its diagnosis is often challenging due to variable clinical presentations and limited access to advanced imaging, especially in resource-constrained settings. Recent research has focused on identifying accessible laboratory markers such as monocyte-to-lymphocyte ratio (MLR) and monocyte-to-high-density lipoprotein ratio (MHR) to improve the overall diagnostic precision for acute appendicitis, extending beyond merely differentiating between uncomplicated and complicated instances.This research focused on assessing the diagnostic significance of the monocyte-to-lymphocyte ratio (MLR), the monocyte-to-high-density lipoprotein cholesterol ratio (MHR), and the Alvarado score for diagnosing acute appendicitis, as well as their effectiveness in distinguishing disease severity among patients at Hasahiesa Emergency Hospital, Gezira State, Sudan.
Methods: A cross-sectional hospital-based study was carried out, enrolling 100 patients diagnosed with acute appendicitis from October 2022 to March 2023. MLR, MHR, and Alvarado scores were assessed for each patient. Their diagnostic performance for acute appendicitis was assessed, and values were compared between uncomplicated and complicated cases. Statistical analysis was performed using SPSS v22.0.
Results: MLR, MHR, and Alvarado scores were significantly elevated in patients with acute appendicitis and showed strong associations with disease severity and ultrasound findings (P value <0.05). These markers demonstrated robust diagnostic value for detecting acute appendicitis in general, as well as for distinguishing between uncomplicated and complicated cases.
Conclusion: MLR, MHR, and Alvarado score are valuable, available aids for diagnosing acute appendicitis and assessing its severity. Their integration into clinical protocols can improve early detection, risk stratification, and clinical decision-making, particularly in settings where advanced imaging is limited.
MLR, MHR, Alvarado scores, Acute appendicitis, Sudan
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