Comparative Analysis of Neutrophil-to-Lymphocyte Ratio (NLR) in Typhoid Fever and Appendicitis Patients at Anutapura General Hospital, Palu
DOI:
https://doi.org/10.31004/joecy.v5i2.1181Keywords:
Typhoid fever, appendicities, neutrophils, lymphocytes, NLRAbstract
The neutrophil-to-lymphocyte ratio (NLR) is a simple, rapid, and cost-effective hematological biomarker used to assess systemic inflammation. Typhoid fever and appendicitis are prevalent infectious diseases that cause acute inflammatory responses, yet comparative studies regarding NLR values between these two conditions are lacking.
The study purpose was to analyze and compare the NLR values in patients with typhoid fever and appendicitis and to evaluate the clinical significance of these findings
Materials and methods. This study employed a quantitative design with a cross-sectional approach at Anutapura General Hospital in Palu. Consecutive sampling was used, involving 54 typhoid fever patients and 57 appendicitis patients. Secondary data were analyzed using the Mann-Whitney and Chi-Square statistical tests.
Results. Typhoid fever was most commonly observed in females (53.7%) and children aged 6-11 years (46.3%). Appendicitis predominantly affected males (54.4%) and late adolescents aged 18-25 years (80.7%). A normal NLR was found in 59.3% of typhoid patients, whereas 94.7% of appendicitis patients exhibited elevated NLR. The mean NLR in typhoid patients was 3.92, and most appendicitis patients had NLR values greater than 3. A statistically significant relationship was found between NLR and appendicitis (p = 0.039), but not with typhoid fever (p=0.076).
Conclusions. NLR elevation is more pronounced and statistically significant in appendicitis than in typhoid fever, suggesting its stronger role as an inflammatory indicator for appendicitis. NLR can be considered a supportive tool in the early differentation of typhoid fever and appendicitis in acute abdominal cases.
References
Ak, R., et al. (2019). Predictive value of scoring systems for the diagnosis of acute appendicitis in emergency department patients: is there an accurate one? Hong Kong Journal of Emergency Medicine, 27(5), 262-269.
Akyuz, M., et al. (2020). Predictive value of neutrophil/lymphocyte ratios in the diagnosis of acute appendicitis. Medical Journal of Bakirkoy, 16-24.
Becker, P., Fichtner-Feigl, S., & Schilling, D. (2018). Clinical Management of Appendicitis. Visceral Medicine, 34(6), 453-458. https://doi.org/10.1159/000496136
Dhinakaran, P., Sreeramulu, P., & Srinivasan, D. (2019). Role of Neutrophil-to-lymphocyte ratio as a predictor of acute appendicitis.
Dinas Kesehatan Provinsi Sulawesi Tengah. (2018). Jumlah Penderita Apendisitis di Sulawesi Tengah.
Erianto, M., Mandala, Z., & Anam, C. R. (2020). Hubungan jumlah kadar limfosit dan neutrofil segmen pada apendisitis akut, Jurnal Ilmiah Kesehatan Sandi Husada, 9(5), 1088-1093
Gunawan, A., Ardilla, N., & Marini, N. C. (2022). Hubungan personal hygiene dengan kejadian demam typhoid pada remaja. Jurnal Kesehatan, 4(2), 404-412.
Hartawan, D., et, al. (2020). Karakteristik kasus apendisitis di Rumah Sakit Umum Pusat Sanglah Denpasar Bali tahun 2018. E-Jurnal Medika Udayana, 9(10), 60-67.
Mustofa, L., Rafie, R., & Salsabila, G. (2020). Karakteristik pasien demam tifoid pada anak dan remaja di RS Pertamina Bintang Amin Lampung. Jurnal Ilmiah Kesehatan Sandi Husada, 9(2), 90-95.
Nurmansyah, D., Putri, S., Wahyuni, A. R., & Nafila. (2023). Profil neutrophil to lymphocyte ratio pada demam tifoid. Asosiasi Institusi Perguruan Tinggi Teknologi Laboratorium Medik Indonesia, 2(1), 17-22.
Putra, I. A. M., et al. (2021). Uji diagnostik rasio neutrofil-limfosit pada apendisitis akut di Rumah Sakit Umum Zainoel Abidin Banda Aceh. Junral Kedokteran Indonesia, 71(4), 170-176.
Raharjo, A. M., Sari, E. D., & Mufida, D. C. (2021). Correlation between leukocyte differential counts with the severity and outcome of COVID-19 patients. Jurnal Respirologi Indonesia, 41(3), 187-195. https://doi.org/10.36497/jri.v41i3.186
Salim, M. A., Danial, D., & Suprapto, B. (2021). Hubungan antara usia, lama keluhan nyeri abdomen, nilai leukosit, dan rasio neutrofil limfosit dengan kejadian apendisitis akut perforasi. Jurnal Sains dan Kesehatan, 3(4), 576-585.
Snyder, M. J., Guthrie, M., & Cagle, S. (2018). Acute appendicitis: Efficient diagnosis and management. American Family Physician, 98(1), 25-33.
Wigiartha, I. K. T. (2018). Hubungan rasio Neutrofil Limfosit dalam memprediksi mortalitas pada pasien peritonitis yang dioperasi di RSUP Sanglah Denpasar.
Wismaya, I. (2018). Perbedaan rasio neutrofil/limfosit pada penderita apendisitis akut tanpa perforasi dan dengan perforasi. Widya Mandala Catholic University thesis.
WHO. (2018). Focus on typhoid fever. World Health Organization.
Yuvela, R. (2022). Gambaran neutrophil-lymphocyte ratio (NLR) pada penderita demam tifoid di wilayah Puskesmas Lepo-Lepo.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Nila Ardilla Arief, Mohamad Zulfikar, Israini Putri, Nur Fadilah Kudek
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
