The Assessment of Laboratory Tests in the Diagnosis of Acute Appendicitis

Marchand, Anthony; Lente, Frederick Van; Galen, Robert S.

doi:10.1016/s0022-5347(17)50674-6

Cited by 16 publications

(29 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Accordingly, the present study shows that an elevated WBC count better detects early appendiceal inflammation, whereas an elevated CRP level better detects protracted inflammation such as that encountered 2 or 3 days after symptom onset [18]. Furthermore, the results of the present study, in which disease severities were mainly determined using CT findings, concur with those of previous studies that were based on surgical-pathological results [7,19].…”

Section: Discussionsupporting

confidence: 88%

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

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 88%

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

View full text Add to dashboard Cite

show abstract

“…The second medical data set was from a published study [37] on the assessment of eight laboratory tests to confirm the diagnosis of acute appendicitis. 85 of the 106 patients had confirmed appendicitis.…”

Section: A Published Data Setsmentioning

confidence: 99%

Dimensionality reduction using genetic algorithms

Raymer

Punch

Goodman³

et al. 2000

IEEE Trans. Evol. Computat.

747

350

View full text Add to dashboard Cite

“…8 Our study has a good correlation of total white blood cell count and had sensitivity ( >80%) and specificity ( >90%) and was selectively accurate in the diagnosis of appendicitis in confusion with other symptoms and signs. 9 An ideal test should be 100% sensitive and specific with a predictive value of 100% with no false positive or negative results, so that the joint probability is 100%. However the 8 variables in the pediatric appendicitis do overlap with other disease as seen in this study, hence single PAS does not give 100% certainly.…”

Section: Discussionmentioning

confidence: 99%

“…9 Other investigations such as pain X-ray abdomen although it was frequently performed but as a part of general evaluation of a patient with an acute abdomen, are rarely helpful in diagnosis of acute appendicitis.…”

Section: Discussionmentioning

confidence: 99%

Paediatric appendicitis scoring: a useful guide to diagnose acute appendicitis in children

et al. 2016

View full text Add to dashboard Cite

Background: Pain in abdomen is common reason for which a child is brought to a surgeon and acute appendicitis is one of the common differential diagnoses in these children. In spite of availability of modern radiological and pathological investigations, even today the diagnosis of acute appendicitis depends mainly on clinical grounds and simple blood count. Pediatrics appendicitis scoring (PAS) which is based on clinical symptoms and sign along with WBC count is a good guide in diagnosis of acute appendicitis. The patient with scoring more than 7, were found to have acute appendicitis and required surgical intervention while those with score <5 could be treated conservatively without any squeal. The Paediatric appendicitis scoring could be helpful to diagnose acute appendicitis early thus reducing morbidity and mortality of the condition by early surgical intervention on one hand and reducing unnecessary exploration on the other. Methods: Patients of acute abdomen admitted in paediatric surgical ward of Kamla Nehru Hospital, Gandhi Medical College, Bhopal, MP, India during the period 14 October 2002 to 03 October 2003 were studied. All the case (25) of acute abdomen suspected to be acute appendicitis were included in this series. A uniform prospective data form was completed which included Demographic data, duration of symptoms, Physical signs, Laboratory, Histopathological examination. Patients were classified into two groups, group I with appendicitis and group 2 nonappendicitis according to final score obtained by each variable. Patients with scoring >7 were included in group I while those with >5 scoring were in group 2. Treatment was given accordingly. (Operative or Non-operative) outcome of the study was noted. Results: In the study, children of age group from 4 to 12 years were included; peak incidence was between 8-10 years, with male: female ratio of 3:1. The size of incidence in both the sex is maximum between 9 to 12 years of age. Tenderness in the rt. Lower quadrant of abdomen on cough/percussion/hopping and tenderness over right iliac fossa has the highest incidence. Leucocytes also has the sensitivity of >75% while anorexia is least sensitive. The patients were grouped in two categories as per the paediatric appendicitis scoring, those patients with PAS >7 were grouped under group I, 10 out of 15 patients underwent appendectomy. Conclusions: Pediatric appendicitis score is a simple relatively accurate diagnostic tool for accessing an acute abdomen and diagnosing acute appendicitis in children. According to this study, PAS is of value in the preclinical evaluation of patients with suspected acute appendicitis and may be instrumental as a quality control tool and in clinical guidelines.

show abstract

The Assessment of Laboratory Tests in the Diagnosis of Acute Appendicitis

Cited by 16 publications

References 0 publications

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

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

Dimensionality reduction using genetic algorithms

Paediatric appendicitis scoring: a useful guide to diagnose acute appendicitis in children

Contact Info

Product

Resources

About