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Abstract

AbstractObjective: To evaluates the prognostic value of preoperative neutrophil-to-lymphocyte ratio (NLR) forpostoperative infectious complications among children with acute appendicitis.Material and Methods: Current prospective cross-sectional research was carried out at Jinnah InternationalHospital, Abbottabad, involving 57 children (aged 5-12) who underwent emergency appendectomy from Oct2023 to Oct 2024. Preoperative medical data, including NLR, were collected. Postoperative complicationswere tracked for one month. SPSS-26 was used fpr Statistical analysis, with logistic regression analysis andto recognize predictors the receiver operating characteristic (ROC) curve analysis was applied.Results: Out of 57 children, 12 (21.1%) developed postoperative complications, primarily superficial surgicalsite infections and prolonged paralytic ileus. The mean NLR was significantly higher in the complication group(12.6 ± 7.97) compared to the non-complication group (5.01 ± 3.45; p < 0.001). Logistic regression identifiedNLR as an independent predictor (OR: 1.24; 95% CI: 1.002-1.58), with an ROC AUC of 0.85, signifyingstrong predictive value. The optimal NLR cutoff was 9.4, with 78.6% sensitivity and 94.3% specificity.Conclusion: In pediatric acute appendicitis, elevated preoperative NLR is a significant predictor of postoperativeinfectious complications. Implementing NLR assessment may help identifying high-risk patients at earlystage, optimizing postoperative monitoring and management to reduce morbidity.Keywords: Neutrophil-To-Lymphocyte Ratio, Acute Appendicitis, Pediatric Surgery, Postoperative Complications,Predictive BiomarkerHow to cite: Iqbal A, Gul H, Khan MTH, Masud S, Shoukat H, Shahid M. Evaluating the Preoperative Neutrophil toLymphocyte Ratio for Predicting Post-operative Infectious Complications In Children with Acute Appendicitis.Esculapio - JSIMS 2025;21(03): 370-376DOI: https://doi.org/10.51273/esc25.251321235