Diagnostic value of C-reactive protein in acute appendicitis

Albu, Eugene; Miller, Barnett M.; Choi, Young Hun; Lakhanpal, Sanjiv; Murthy, Rachna; Gerst, Paul H.

doi:10.1007/bf02047214

Cited by 49 publications

(39 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The diagnostic value of CRP and WBC has been established in patients with appendicitis [11,25,[27][28][29][30][31][32]. It has been demonstrated that CRP could differentiate between children with non-perforated from children with perforated appendicitis [25]; this observation has also been reported in adults [28,32].…”

Section: Laboratory Tests: Wbc and Crpmentioning

confidence: 69%

Is hyperbilirubinaemia in appendicitis a better predictor of perforation than C-reactive protein? — a prospective study

Beltrán¹,

Méndez²,

Barrera³

et al. 2009

Indian J Surg

View full text Add to dashboard Cite

Purpose To compare the performance for the prediction of perforated appendicitis of total bilirubin versus C-reactive protein (CRP), white blood cell count, the time period of symptoms' evolution, and systemic infl ammatory response syndrome (SIRS).Methods Prospective observational study, applying receiver operating characteristics curve analysis to compare the sensitivity and specifi city of the tested variables. ResultsThe period of symptom's evolution was prolonged (105.2 ± 79.3 hours vs. 38.6 ± 17.5 hours), and CRP levels were higher in perforated appendicitis (176 ± 82.6 mg/l vs. 80 ± 76 mg/l). Most patients with perforated appendicitis had a SIRS score higher than 3 points. CRP (>76.7 mg/l), the time period of symptoms' evolution (>34.5 hours), and SIRS (3 points or more), were the best cutoff values to predict perforated appendicitis.Conclusions Perforated appendicitis may be suspected based on CRP, SIRS and the time period of symptoms' evolution. We do not recommend the use of total bilirubin to predict perforation in appendicitis.

show abstract

Section: Laboratory Tests: Wbc and Crpmentioning

confidence: 69%

Is hyperbilirubinaemia in appendicitis a better predictor of perforation than C-reactive protein? — a prospective study

Beltrán¹,

Méndez²,

Barrera³

et al. 2009

Indian J Surg

View full text Add to dashboard Cite

show abstract

“…Albu et al evaluated level of CRP in cases of AA and reported that sensitivity and specificity were 100% and 84.6%, respectively, when cut-off value was 2.5 mg/dL. [12] In study performed by Mengücük et al, CRP level of patients with pathological diagnosis of appendicitis (focal, suppurative, or perforated) was statistically significantly higher when compared with cases that did not have pathological diagnosis of appendicitis. [13] In another study conducted by Sack et al, CRP level of group with PA and group with abdominal pain who did not undergo surgery was compared.…”

Section: Discussionmentioning

confidence: 99%

Ischemia modified albumin and other inflammatory markers in the diagnosis of appendicitis in children

Nazik

Avcı²,

Kiraz³

2016

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

show abstract

“…5 However, if the C-reactive protein level in blood drawn 12 hours after the onset of symptoms is less than 2.5 mg/dL, acute appendicitis can be excluded. 6 The triple test (WBC count, CRP and Neutrophil percentage) is recommended as a help in reducing the significant rate of negative laparotomies in patients suspected of having acute appendicitis. 7 We found that elevated serum CRP levels support surgeon's clinical diagnosis.…”

Section: Review Of Literaturementioning

confidence: 99%

Sensitivity and Specificity of Neutrophil Count, Crp, Leukocyte Count and Usg Abdomen in the Diagnosis of Acute Appendicitis: A Retrospective Study

P¹,

H²,

Madhumitha³

2016

jemds

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVESAcute appendicitis is the most common cause of acute surgical abdomen and appendicectomy is the most commonly done emergency surgery. Its diagnosis remains an enigmatic challenge, plagued by a high rate of negative explorations (15-30%). There is no single reliable test with satisfactory sensitivity and specificity. The objective of the study was to evaluate role of few known and proven investigations for appendicitis like CRP, leukocyte count, Neutrophil count and Ultrasonography in diagnosing acute appendicitis and reducing the rate of negative appendicectomies. Also we wanted to study whether combining the investigations in same patient would improve the diagnostic accuracy. METHODSThe present study was conducted in 100 patients who have been clinically diagnosed of having Acute Appendicitis and posted for emergency appendicectomy in General Surgery Department of Sri Venkateshwaraa Medical College and Hospital, Pondicherry, during the period from 1st May 2015 to 31st December 2015. Preoperatively blood for CRP, WBC count, Neutrophil count and USG abdomen were done. All appendicectomy specimens were subjected to histopathological examination postoperatively, which was taken as gold standard. Results of all the four investigations were correlated with HPE reports to evaluate their role in diagnosis of acute appendicitis. RESULTSIn present study, CRP has highest sensitivity and specificity (90%, 80%) followed by USG (87.5%, 90%), WBC count (78.75%, 80%) and Neutrophil count (77.5%, 80%). Combining CRP and WBC count increases the sensitivity and specificity of the tests (96.25%, 80%). When all the four tests are combined (Either/all) the sensitivity, specificity, positive predictive value and predictive value of negative test increases significantly (100%, 80%, 95.23%, 100% respectively). It was observed that when all the four tests were negative appendicitis could be safely ruled out and surgery can be deferred in these patients. It would reduce the rate of negative appendicectomies. INTERPRETATIONS AND CONCLUSIONSCRP contains important diagnostic information and hence should always be included in the diagnostic workup of acute appendicitis. The sensitivity of WBC count and Neutrophil count is low individually, but when combined with CRP the sensitivity and specificity increases. Ultrasonography is useful in establishing alternative diagnoses, but its availability and cost-effectiveness should be taken into account. Combining all four investigations significantly increases the diagnostic accuracy. Also when all four tests are negative acute appendicitis is very unlikely and surgery can be safely deferred in these patients thereby reducing the negative appendicectomy rates. We continue to stress that history and clinical examination by a skilled surgeon still remains indispensable in diagnosing acute appendicitis and its importance cannot be undermined. The investigations can be used to complement a Surgeon's clinical diagnosis and not replace it.

show abstract

Diagnostic value of C-reactive protein in acute appendicitis

Cited by 49 publications

References 5 publications

Is hyperbilirubinaemia in appendicitis a better predictor of perforation than C-reactive protein? — a prospective study

Is hyperbilirubinaemia in appendicitis a better predictor of perforation than C-reactive protein? — a prospective study

Ischemia modified albumin and other inflammatory markers in the diagnosis of appendicitis in children

Sensitivity and Specificity of Neutrophil Count, Crp, Leukocyte Count and Usg Abdomen in the Diagnosis of Acute Appendicitis: A Retrospective Study

Contact Info

Product

Resources

About