CRP in Acute Appendicitis — Is It a Necessary Investigation?

Amalesh, T.; Shankar, Mrinal; Shankar, Raghu

doi:10.1016/s1743-9191(06)60050-2

Cited by 32 publications

(32 citation statements)

References 19 publications

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“…Therefore, CRP may be useful to differentiate LH from acute appendicitis, but not useful to determine the severity of inflammation. On the contrary, Amalesh et al [19] noted that neither elevated nor normal CRP level was helpful in the diagnosis of acute appendicitis. This result may be due to the pediatric patient population of their study.…”

Section: Discussionmentioning

confidence: 97%

How To Avoid Negative Appendectomies: Can Us Achieve This?

Kartal¹

2016

Ulus Travma Acil Cerrahi Derg

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Section: Discussionmentioning

confidence: 97%

How To Avoid Negative Appendectomies: Can Us Achieve This?

Kartal¹

2016

Ulus Travma Acil Cerrahi Derg

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“…The reported predictive values of CRP in appendicitis vary widely: reported sensitivities range from 40% to 99% and specificities from 27% to 90% [17]. Amalesh et al [11] reported that the accuracy of CRP for diagnosing acute appendicitis is low and added that CRP levels are not useful when deciding on surgery. However, Ortega-Deballon et al [5] recently concluded that CRP level is the most useful laboratory parameter in terms of diagnosing acute appendicitis and that CRP levels are strongly correlated with inflammation severity.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, some investigators have stressed the importance of these blood inflammatory markers in the context of deciding upon discharge or admission for further investigation [5][6][7][8][9][10]. However, some reports show that these inflammatory markers have low diagnostic accuracy in acute appendicitis [11][12][13]. As a result of these disparate results, the importance of WBC counts and CRP levels during the diagnostic stage remains controversial.…”

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confidence: 99%

Acute appendicitis: relationships between CT-determined severities and serum white blood cell counts and C-reactive protein levels

Kim

Yang²,

Lee³

et al. 2011

BJR

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Objectives: The aim of this study was to evaluate the relationships between the severity of appendicitis as depicted on CT and blood inflammatory markers of serum white blood cell (WBC) count and C-reactive protein (CRP). Methods: CT images in 128 patients (109 surgically proven and 19 with clinically excluded appendicitis) were retrospectively reviewed. Two radiologists by consensus evaluated and scored (using a 0, 1 or 2 point scale) severities based on CT-determined appendiceal diameters, appendiceal wall changes, caecal changes, periappendiceal inflammatory stranding and phlegmon or abscess formation. We investigated whether CT findings were significantly related to elevated WBC counts or CRP levels and performed the correlations of WBC counts and CRP levels with CT severity scores. Patients were also subjectively classified using four grades from normal (Grade I) to perforated appendicitis (Grade IV) on the basis of CT findings to evaluate differences in WBC counts and CRP levels between grades. Results: Only appendiceal wall changes and the phlegmon or abscess formation were related to elevated WBC counts and CRP levels, respectively (p,0.05). CT severity scores were found to be more strongly correlated with CRP levels (r50.669) than with WBC counts (r50.222). On the basis of CT grades, the WBC counts in Grade I were significantly lower than in other grades (p,0.001), whereas CRP levels in Grade IV were significantly higher than in other grades (p,0.001). Conclusion: CRP levels were found to correlate with CT-determined acute appendicitis severity and could be a useful predictor for perforated appendicitis, whereas WBC counts might be useful to detect early acute appendicitis.

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“…[9][10][11][12][13][14] In such condition clinical and laboratory investigations may be the only, cheaper and readily available options for diagnosis. In this study we have tried to compare the difference in the level of serum bilirubin between patients with gangrenous and non-gangrenous appendicitis.…”

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confidence: 99%

Role of serum bilirubin as a marker of acute gangrenous appendicitis

2012

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Background: This study has compared the difference in serum bilirubin between patients with gangrenous and non-gangrenous appendicitis. Methods: A prospective analytical study of, 141 patients who underwent appendectomy, from March 2010 to March 2011 in Manipal Teaching Hospital, Pokhara, Nepal was carried out. Clinico-demographic data, Alvarado’s score, total serum bilirubin, total leucocyte count and histopathological report of all the cases were collected in a prestructured proforma. Comparison between gangrenous and non-gangrenous appendicitis groups was carried out using independent sample t test, Chisquare test, and direct logistic regression. The data was analyzed using SPSS 11.6 software. Result: Around 43% (61 out of 141) patients had gangrenous appendicitis and statistically significant difference was found between the two groups in total Alvarado’s score, total count and total bilirubin level. The effect size as indicated by eta square statistics was large for total bilirubin (eta squared=0.39) as compared to total Alvarado’s score (0.09) and total leucocyte count (0.05). Direct logistic regression model showed serum total bilirubin as the only independent variable to make a unique statistically significant contribution in predicting gangrenous appendicitis. Conclusion: Pre-operative assessment of serum total bilirubin can serve as an important maker of acute gangrenous appendicitis. DOI: http://dx.doi.org/10.3126/njms.v1i2.6606 Nepal Journal of Medical Sciences. 2012;1(2): 89-92

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CRP in Acute Appendicitis — Is It a Necessary Investigation?

Abstract: We conclude that neither raised nor normal CRP value is helpful in the diagnosis of acute appendicitis. CRP is not a good tool for helping the surgeon make the diagnosis of appendicitis and it should not be measured in suspected appendicitis.

Cited by 32 publications

References 19 publications

How To Avoid Negative Appendectomies: Can Us Achieve This?

How To Avoid Negative Appendectomies: Can Us Achieve This?

Acute appendicitis: relationships between CT-determined severities and serum white blood cell counts and C-reactive protein levels

Role of serum bilirubin as a marker of acute gangrenous appendicitis

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