C-reactive protein is superior to bilirubin for anticipation of perforation in acute appendicitis

Käser, Samuel; Fankhauser, Gerhard; Willi, Niels; Maurer, Christoph A.

doi:10.3109/00365521003728572

Cited by 69 publications

(53 citation statements)

References 16 publications

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“…Bazı çalışmalar CRP'nin özellikle komplike apandisitli olguları tahmin etmede daha yararlı olduğunu bildirmiştir. [1,12,16,25] Yang ve ark.nın akut apandisit şüphesi ile opere edilen 897 hastada yaptıkları çalışmada normal apendiksli olgular için CRP ortalaması 39.6 mg/L, inflame apandisitli olgular için 24.1 mg/L, perfore apandisitli olgular için 96.8 mg/L olarak hesaplamışlar ve gruplar arasında istatistiksel olarak anlamlı farkı oluşturan grubun perfore apandisitli olgular olduğunu saptamışlardır. [8] Grönroos ve ark.nın yaptıkları çalışmada akut apandisit tanısı ile opere edilen olguları incelediklerinde CRP düzeyleri açısın-dan normal apendiksli ve komplike olmayan olgularda anlamlı bir fark bulunmazken (CRP düzeyleri sırasıyla 32 mg/L ve 31 mg/L) komplike olgulardaki yükseklik (CRP düzeyi 99 mg/L) istatistiksel olarak anlamlı bulunmuştur.…”

Section: Discussionunclassified

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Predictive Value of Leucocyte Count, Neutrophil Percent and C-Reactive Protein Concentration “Cut-Off Value” On The Diagnose Of Appendicitis

Ayrık

Karaaslan

Dağ

et al. 2015

Ulus Travma Acil Cerrahi Derg

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Section: Discussionunclassified

“…C-reaktif proteinin sensitivite ve spesifitesinin komplike olan olgularda literatür-le uyumlu olarak daha yüksek olduğu tespit edildi. [16,25] Akut apandisitli olgularda CRP düzeyi ne kadar yüksek saptanırsa hastanın komplike olma olasılığı o kadar yüksektir diyebiliriz.…”

Section: Discussionunclassified

Predictive Value of Leucocyte Count, Neutrophil Percent and C-Reactive Protein Concentration “Cut-Off Value” On The Diagnose Of Appendicitis

Ayrık

Karaaslan

Dağ

et al. 2015

Ulus Travma Acil Cerrahi Derg

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“…Nevertheless, various studies on risk factors for complicated appendicitis suggested that health care providers all over the world desire to be able to predict cases with less favorable outcomes and to be prepared for such circumstances. Serum WBC counts have been used for the diagnosis of acute appendicitis (28), and several studies explored the application of laboratory values in differentiating complicated acute appendicitis (20)(21)(22)29).…”

Section: Discussionmentioning

confidence: 99%

Risk factors for the development of complicated appendicitis in adults

Naderan

Babaki

Shoar

et al. 2016

UCD

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Objective: To investigate the patient's history and physical examination information to find out risk factors associated with complicated appendicitis. Material and Methods:Two hundred patients who were admitted with complicated appendicitis (including abscess, phlegmon, and generalized peritonitis) were retrieved from our database. Two hundred patients with non-complicated acute appendicitis were randomly selected from the same period. These two groups were compared in terms of demographic characteristics, past medical history, and presenting symptoms. We made a multivariate analysis model using binary logistic regression and backward stepwise elimination. Results:Based on multivariate analysis, risk factors for complicated appendicitis included presenting with epigastric pain (OR=3.44), diarrhea (OR=23.4) or malaise (OR=49.7), history of RLQ pain within the past 6 months (OR=4.93), older age (OR=1.04), being married (OR=2.52), lack of anorexia (OR=4.63) and longer interval between onset of symptoms and admission (OR=1.46). Conversely, higher (academic) education was associated with decreased odds for complicated appendicitis (OR=0.26). Conclusion:Our findings suggest that a surgeon's clinical assessment is more reliable to make a judgment. "Bedside evaluation" is a useful, cheap, quick and readily available method for identifying those at risk for developing complicated acute appendicitis.

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“…[12][13][14][15][16] C-reactive protein (CRP) was reported to be superior to bilirubin for anticipation of perforation in acute appendicitis. 17 Neutrophil-to-lymphocyte ratio (NLR) was introduced as a predictor of complicated appendicitis, but their sensitivity and specificity is not better than that of bilirubin or CRP.…”

Section: Introductionmentioning

confidence: 99%

Delta neutrophil index: A reliable marker to differentiate perforated appendicitis from non‐perforated appendicitis in the elderly

Shin

Cho

Kim

et al. 2017

Clinical Laboratory Analysis

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Background Delta neutrophil index (DNI) is a new inflammatory marker and the present study aimed to evaluate the predictive value of the DNI for the presence of a perforation in elderly with acute appendicitis. Methods This retrospective observational study was conducted on 108 consecutive elderly patients (≥65 years old) with acute appendicitis treated over a 24‐month period. Results Sixty‐nine of the 108 patients (median, IQR: 72, 67‐77 years) were allocated to the perforated appendicitis group (63.9%) and 39 to the non‐perforated appendicitis group (36.1%). WBC, neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio and DNI were significantly higher in the perforated group. In multiple logistic regression analyses, initial DNI was the only independent marker that can significantly predict the presence of perforation in multiple regression [odds ratio 9.38, 95% confidence interval (2.51‐35.00), P=.001]. Receiver operator characteristic curve analysis showed that DNI is a good predictor for the presence of appendiceal perforation at an optimal cut‐off for DNI being 1.4% (sensitivity 67.7%, specificity 90.0%, AUC 0.807). Conclusion Clinicians can reliably differentiate acute perforated appendicitis from non‐perforated appendicitis by DNI level of 1.4 or more in elderly patients.

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C-reactive protein is superior to bilirubin for anticipation of perforation in acute appendicitis

Abstract: Our results confirm hyperbilirubinemia to be a statistically significant marker of perforation in acute appendicitis. However, CRP is superior to bilirubin for anticipation of perforation in acute appendicitis.

Cited by 69 publications

References 16 publications

Predictive Value of Leucocyte Count, Neutrophil Percent and C-Reactive Protein Concentration “Cut-Off Value” On The Diagnose Of Appendicitis

Predictive Value of Leucocyte Count, Neutrophil Percent and C-Reactive Protein Concentration “Cut-Off Value” On The Diagnose Of Appendicitis

Risk factors for the development of complicated appendicitis in adults

Delta neutrophil index: A reliable marker to differentiate perforated appendicitis from non‐perforated appendicitis in the elderly

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