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  • Title: Influence of white cell count on surgical decision making in patients with abdominal pain in the right lower quadrant.
    Author: Vermeulen B, Morabia A, Unger PF.
    Journal: Eur J Surg; 1995 Jul; 161(7):483-6. PubMed ID: 7488661.
    Abstract:
    OBJECTIVE: To evaluate the influence of white cell count (WCC) on the decision to operate on patients with right lower abdominal pain. DESIGN: Open study. SETTING: University hospital, Switzerland. SUBJECTS: 221 adult patients admitted to emergency department with right lower abdominal pain. INTERVENTIONS: Surgeons were unaware of the WCC until after they had initially decided whether to remove the appendix. They were told the result and asked if it would influence their final decision. MAIN OUTCOME MEASURE: Whether surgeons changed their minds about operation when told the initial WCC. RESULTS: 112 Patients (51 men and 61 women) were operated on, of which 44 men (52%) and 42 women (31%) had histologically confirmed appendicitis. The decision to operate was influenced by the initial WCC in only 6 patients (3%, 95% confidence interval (CI) 0.6 to 4.9%). At follow up after 30 days the change of decision in the 6 patients had been correct in 5. CONCLUSION: The WCC did not significantly influence surgical decision-making in the group of patients who were suspected of having acute appendicitis.
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