{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T14:02:26Z","timestamp":1784901746722,"version":"3.55.0"},"reference-count":30,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fuling District Medical Scientific Research Project","award":["2023KWLH016"],"award-info":[{"award-number":["2023KWLH016"]}]},{"name":"Fuling District Medical Scientific Research Project","award":["flyygzpy2026011"],"award-info":[{"award-number":["flyygzpy2026011"]}]},{"name":"Special Fund for Public Hospital Reform and High-Quality Development Demonstration Project","award":["2023KWLH016"],"award-info":[{"award-number":["2023KWLH016"]}]},{"name":"Special Fund for Public Hospital Reform and High-Quality Development Demonstration Project","award":["flyygzpy2026011"],"award-info":[{"award-number":["flyygzpy2026011"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Cir. Bras."],"abstract":"<jats:p>ABSTRACT  Purpose: We investigated the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) and combined them to create an inflammatory marker, the combined neutrophil-platelet score (CNPS), to serve as a diagnostic and predictive tool for complicated appendicitis.  Methods: A retrospective analysis was conducted on the clinicopathological data of patients who underwent appendectomy. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to evaluate the diagnostic performance of various inflammatory parameters. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for complicated appendicitis. A prospective study was then carried out to validate the clinical utility of the CNPS.  Results: In total, 322 patients were included in the retrospective analysis. Multivariate analysis identified only onset time and NLR as independent risk factors for complicated appendicitis, whereas the PLR was not. CNPS demonstrated superior diagnostic and predictive performance for complicated appendicitis compared to NLR and PLR. Moreover, after adjusting for confounders, CNPS remained an independent risk factor for complicated appendicitis. In the prospective study, 264 patients were included for analysis, and the AUC of CNPS for predicting complicated appendicitis was 0.707.  Conclusion: The CNPS, combining NLR and PLR, demonstrates high diagnostic and predictive value for complicated appendicitis.<\/jats:p>","DOI":"10.1590\/acb413926","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T13:12:42Z","timestamp":1784898762000},"source":"Crossref","is-referenced-by-count":0,"title":["A novel combined neutrophil-platelet score for diagnosing complicated appendicitis: a retrospective and prospective cohort study"],"prefix":"10.1590","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0239-8195","authenticated-orcid":false,"given":"Xiang","family":"Li","sequence":"first","affiliation":[{"name":"Chongqing University,  China; Chongqing University,  China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8089-2668","authenticated-orcid":false,"given":"Jiangshun","family":"Yang","sequence":"additional","affiliation":[{"name":"Chongqing University,  China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8316-4152","authenticated-orcid":false,"given":"Dengyang","family":"Fang","sequence":"additional","affiliation":[{"name":"Chongqing University,  China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4828-9695","authenticated-orcid":false,"given":"Wei","family":"Dai","sequence":"additional","affiliation":[{"name":"Chongqing University,  China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3977-734X","authenticated-orcid":false,"given":"Zuming","family":"Xiong","sequence":"additional","affiliation":[{"name":"Chongqing University,  China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5743-3454","authenticated-orcid":false,"given":"Xuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Chongqing University,  China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"issue":"19","key":"ref1","doi-asserted-by":"crossref","first-page":"362","DOI":"10.21037\/atm.2016.09.10","article-title":"Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases","volume":"4","author":"Cervellin G","year":"2016","journal-title":"Ann Transl Med"},{"issue":"1","key":"ref2","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13017-020-00306-3","article-title":"Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines","volume":"15","author":"Di Saverio S","year":"2020","journal-title":"World J Emerg Surg"},{"issue":"10000","key":"ref3","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1016\/S0140-6736(15)00275-5","article-title":"Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management","volume":"386","author":"Bhangu A","year":"2015","journal-title":"Lancet"},{"issue":"11","key":"ref4","doi-asserted-by":"crossref","first-page":"2347","DOI":"10.1007\/s00384-021-03940-8","article-title":"Classification of acute appendicitis (CAA): treatment directed new classification based on imaging (ultrasound, computed tomography) and pathology","volume":"36","author":"Hoffmann JC","year":"2021","journal-title":"Int J Colorectal Dis"},{"issue":"5","key":"ref5","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1093\/oxfordjournals.aje.a115734","article-title":"The epidemiology of appendicitis and appendectomy in the United States","volume":"132","author":"Addiss DG","year":"1990","journal-title":"Am J Epidemiol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.ijsu.2017.03.022","article-title":"Is laparoscopic appendectomy feasible for complicated appendicitis? 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