Inclusion of C-Reactive Protein and White Blood Cell Count in Diagnostic Workup of Patients with Clinically Suspected Appendicitis Stratifies for Imaging

نویسندگان

  • R. R van Tol
  • S. O. Breukink
  • M. J. Lahaye
  • JPM. Derikx
چکیده

Objectives: The aim of this retrospective study was to clarify whether plasma markers that are routinely used in the workup of patients suspected for acute appendicitis (AA) can stratify for imaging in both adults and children. Methods: A total of 1388 patients suspected of AA between January 2008 and till 2012 were included. CRP and WBC concentrations were retrospectively abstracted from the electronic health record. Receiver operating characteristic (ROC) curves were used to assess the diagnostic accuracy for the tests and to determine the best cutoff points. Results: In total 432 (22.4%) patients had histopathologically proven AA of whom 45 patients (10.4%) had perforated appendictis. The area under the curve (AUC 95% confidence interval [CI]) was 0.74 (95% CI = 0.70 to 0.77) for CRP and 0.74 (95% Cl = 0.71 to 0.78) for WBC both in adults and children. No cut off points had high enough sensitivity and specificity to accurately diagnose (perforated) AA. However, a high sensitivity of 91% was shown at cut-off 7.5x109/L WBC for AA (both in adults and children). In total 244 (18%) had a cut-off < 7.5×109/L. Those patients could have been sent home. Only 21 (5%) patients would have been missed in the AA group and 1(0.5%) patient in the perforated appendicitis group. Conclusions: None had clinical relevant cutoff points that could accurately discriminate between AA and other pathology, neither perforated appendicitis. However, WBC < 7.5×109/L for AA can identify a subgroup of 245 out of 1388 (18%) patients that could have been sent home without further imaging.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Relationships of Serum Level of High- Sensitivity C- Reactive Protein (hs- CRP) and White Blood Cell (WBC) Count with Gamma- Glutamyltransferase among Iranian Healthy Adults

Background & Objective: There are many common infections and inflammations among people over the world. This demands an affordable and reliable test with high sensitivity/specificity to predict or confirm the diagnosis of such cases in routinely clinical practice. In the present study, we aimed to find any potential correlation between serum levels of GGT and CRP- Q and/or hs- CRP and ...

متن کامل

تعیین ارزش تشخیصی آزمایش C-Reactive Protein در موارد مشکوک به آپاندیسیت

    Background & Aim: The patients suspected of appendicitis are evaluated by history, physical examinations and laboratory results. The aim of this study was to assess the diagnostic value of C-reactive protein in patients with suspected acute appendicitis. Patients & Method: In a prospective study, 299 patients with acute abdominal pain who had been admitted to hospital for observation were e...

متن کامل

The diagnostic value of C-reactive protein, white blood cell count and neutrophil percentage in childhood appendicitis.

OBJECTIVE To analyze the value of C-reactive protein (CRP), total white blood cell count (WBC), and neutrophil percentage in the diagnosis of suspected cases of childhood appendicitis. METHODS Prospective study of 216 patients admitted with a history of suspected acute appendicitis, between October 2001 through to May 2002, Al Fateh Teaching Hospital for Children, Benghazi, Libya. Blood sampl...

متن کامل

Role of serum C-reactive protein and leukocyte count in the diagnosis of acute appendicitis in Nepalese population.

Various diagnostic modalities have been reported to influence the negative appendicectomy. C-reactive protein (CRP), an acute phase reactant, may improve the accuracy of diagnosing acute appendicitis. The present study was undertaken to evaluate the utility of CRP as a diagnostic tool among patients clinically suspected to have acute appendicitis. The role of total leukocyte (WBC) count was als...

متن کامل

بررسی ارزش تشخیصی پروتئین واکنشی C در آپاندیسیت حاد بزرگسالان

  Background and Aim: Acute appendicitis is a common cause of abdominal pain and it can be difficult to diagnose, especially during the early stages. The role of inflammatory markers in the diagnosis of acute appendicitis has not been clearly defined. The aims of this prospective audit were to define the role of C-reactive protein and the other serum markers of inflammation, total white cell an...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره   شماره 

صفحات  -

تاریخ انتشار 2016