Evaluating the Role of C-reactive Protein in Reducing the Rate of Negative Appendicectomies

Abstract

Background: Acute appendicitis is a common surgical condition of the abdomen. However, diagnostic difficulties may arise, resulting in high rate of negative appendicectomies. This study aimed to assess the role of C-reactive protein (CRP) in improving the                                  accuracy of diagnosis of acute appendicitis and thus reducing the rate of negative appendicectomies. Materials and Method: The study was a cross-sectional, hospital-based study carried out on 66 patients who had appendicectomy following a clinical diagnosis of acute appendicitis. Samples for CRP were collected from all recruited patients preoperatively.  Following appendicectomy, the appendix was sent for histology. A proforma was used to collect data. All the statistical analyses were performed using IBM statistics package for social sciences (SPSS) version 21. At 95% confidence level, p-values less than 0.05 were considered significant. Results: Thirteen (13) of the appendices removed had normal histopathologic examination, giving a negative appendicectomy rate of 19.7%. The diagnostic accuracy, sensitivity, specificity and positive predictive value for preoperative CRP were 80%, 79%, 85% and 95% respectively. Conclusion: An elevated level of  CRP is a useful aid for the diagnosis of acute appendicitis. Deferring surgery in patients with normal CRP would likely decrease the incidence of negative appendicectomies.