Correlation of serum C-reactive protein, white blood count and neutrophil percentage with histopathology findings in acute appendicitis

World Journal of Emergency Surgery

Avdyl Krasniqi¹  Fatos Sada⁴  Besnik Bicaj¹  Fahredin Veselaj²  Kumrije Xharra⁶  Lumturije Gashi-Luci⁵  Shefki Xharra³ 

[1] Department of Abdominal Surgery, University Clinical Center of Kosovo, Prishtina, Kosovo;Department of Urology, University Clinical Center of Kosovo, Prishtina, Kosovo;Department of Surgery, Regional Hospital, Prizren, Kosovo;Department of Anesthesiology, University Clinical Center of Kosovo, Prishtina, Kosovo;Institute of Pathology, Faculty of Medicine, University of Prishtina, Prishtina, Kosovo;Department of Microbiology, National Institute of Public Health of Kosovo, Prishtina, Kosovo

关键词: Histopathology findings;    Neutrophil percentage;    White blood count;    CRP correlation;    Acute appendicitis;   

Others  :  792228
DOI  :  10.1186/1749-7922-7-27

 received in 2012-06-25, accepted in 2012-07-31,  发布年份 2012

【 摘 要 】

Background

Acute appendicitis is one of the most common surgical emergencies. Accurate diagnosis of acute appendicitis is based on careful history, physical examination, laboratory and imaging investigation. The aim of the study is to analyze the role of C-reactive protein (CRP), white blood count (WBC) and Neutrophil percentage (NP) in improving the accuracy of diagnosis of acute appendicitis and to compare it with the intraoperative assessment and histopathology findings.

Materials and methods

This investigation was a prospective double blinded clinical study. The study was done on 173 patients surgically treated for acute appendicitis. The WBC, NP, and measurement of CRP were randomly collected pre-operatively from all involved patients. Macroscopic assessment was made from the operation. Appendectomy and a histopathology examination were performed on all patients. Gross description was compared with histopathology results and then correlated with CRP, WBC, and NP.

Results

The observational accuracy was 87,3%, as compared to histopathological accuracy which was 85.5% with a total of 173 patients that were operated on. The histopathology showed 25 (14.5%) patients had normal appendices, and 148 (85.5%) patients had acutely inflamed, gangrenous, or perforated appendicitis. 52% were male and 48% were female, with the age ranging from 5 to 59 with a median of 19.7. The gangrenous type was the most frequent (52.6%). The WBC was altered in 77.5% of the cases, NP in 72.3%, and C-reactive protein in 76.9% cases. In those with positive appendicitis, the CRP and WBC values were elevated in 126 patients (72.8%), whereas NP was higher than 75% in 117 patients (67.6%). Out of 106 patients with triple positive tests, 101 (95.2%) had appendicitis. The sensitivity, specificity, and positive predictive values of the 3 tests in combination were 95.3%, 72.2%, and 95.3%, respectively.

Conclusion

The raised value of the CRP was directly related to the severity of inflammation (p-value <0.05). CRP monitoring enhances the diagnostic accuracy of acute appendicitis. The diagnostic accuracy of CRP is not significantly greater than WBC and NP. A combination of these three tests significantly increases the accuracy. We found that elevated serum CRP levels support the surgeon's clinical diagnosis.

【 授权许可】

   
2012 Xharra et al.; licensee BioMed Central Ltd.

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