Could C-reactive protein be a potential biomarker of complicated acute appendicitis?
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AbstractIntroduction: The purpose of this study is to evaluate the diagnostic value of C-reactive protein (CRP) to identify complicated appendicitis (defined as perforation, abscess or gangrenous appendicitis) versus simple appendicitis. Methods: A retrospective study was performed in the emergency department (ED) of Prince of Wales Hospital in the New Territories of Hong Kong. The clinical records of patients admitted to the surgical wards via the ED over 17 months were reviewed by a research assistant. We included all patients aged >13 years who had a provisional diagnosis of "acute appendicitis" or "right lower quadrant pain". We excluded patients with pregnancy, previous appendicectomy, incomplete medical records or no CRP levels determined before operation and those who discharged themselves from hospital against medical advice after admission. The outcome of this study was the CRP level in relation to the presence of complicated appendicitis. ROC curve analysis was employed to identify the optimum cut-off level of CRP which had the best sensitivity and specificity to identify complicated appendicitis compared to simple appendicitis. Results: Forty-two patients were diagnosed to have acute appendicitis, 31 of whom had complicated appendicitis. CRP level was higher in the group of complicated appendicitis (p<0.05). We identified an optimum cut-off value for CRP of 40.1 mg/L to discriminate between complicated and non-complicated appendicitis. The sensitivity and specificity of CRP to identify complicated appendicitis were 71.0% and 100% respectively at this cut-off level. Conclusion: High CRP levels could possibly predict the diagnosis of complicated appendicitis and facilitate more appropriate surgical care. This finding needs to be confirmed in prospective and larger multicentre studies.
All Author(s) ListLai C.Y., Leung Y.K., Graham C.A.
Journal nameHONG KONG JOURNAL OF EMERGENCY MEDICINE
Year2014
Month1
Day1
Volume Number21
Issue Number6
PublisherMedcom Limited
Place of PublicationHong Kong
Pages354 - 360
ISSN1024-9079
LanguagesEnglish-United Kingdom
KeywordsComplication, Diagnosis, Predictive value of test, Sensitivity and specificity

Last updated on 2021-14-10 at 23:36