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Influence of white cell count on surgical decision making in patients with abdominal pain in the right lower quadrant.

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.