A. Khan, Abdul Manan, Irfan Ahmad, T. Mahar, Muhammad Usman, Abdul Qadir
{"title":"C -Reactive Protein, Leukocyte Count and Neutrophils: A Diagnostic Aid in Acute Appendicitis","authors":"A. Khan, Abdul Manan, Irfan Ahmad, T. Mahar, Muhammad Usman, Abdul Qadir","doi":"10.35787/jimdc.v11i4.741","DOIUrl":null,"url":null,"abstract":"Background: Many clinical methods, scoring systems, radiological and laboratory investigations are used to diagnose and differentiate simple from complicated appendicitis. Proactive approach results in high rate of negative appendectomies and conservative approach results in increased rate of post-operative complications. The objective of this study was to evaluate the role of CRP, TLC and Neutrophil percentage in the diagnosis and differentiation of simple and complicated appendicitis. \nMethodology: This cross sectional study was conducted at department of Surgery, Nishtar medical university/hospital, Multan from 1st November, 2019 to 30th April, 2021. Blood samples from patients were collected after admission, for CRP, TLC and Neutrophil percentage. Data were collected and analyzed through SPSS version 23. \nResults: A total of 320 patients more than 12 years of age, 168 (52.5%) male and 152 (47.5%) female with 1.10:1, were included in the study. Sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) of CRP were 90.6%, 80%, 96% and 61.5% for acute appendicitis and 96.7%, 80%, 98.3%, and 66.7% for perforated appendicitis respectively with p-value of <0.000. Sensitivity, specificity, PPV and NPV of TLC were 87.5%, 80%, 95.9% and 54.5% for acute and 93.3%, 90%, 99.1% and 52.9% for perforated appendicitis with p= <0.000. Sensitivity, specificity, PPV and NPV of Neutrophils, in acute and perforated appendicitis were 83.8%, 76.7%, 95%, and 46.9% versus 87.5%, 70%, 97.2%, 31.8% respectively with P-value < 0.000. \nConclusion: Sensitivity, specificity and PPV of CRP, TLC and Neutrophils increased with the severity of appendicitis. Combining the results of the above three markers increased the diagnostic accuracy. \nKeywords: Acute appendicitis, CRP (C-reactive protein), TLC (Leukocyte count) and Neutrophils.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Islamabad Medical and Dental College","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.35787/jimdc.v11i4.741","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Many clinical methods, scoring systems, radiological and laboratory investigations are used to diagnose and differentiate simple from complicated appendicitis. Proactive approach results in high rate of negative appendectomies and conservative approach results in increased rate of post-operative complications. The objective of this study was to evaluate the role of CRP, TLC and Neutrophil percentage in the diagnosis and differentiation of simple and complicated appendicitis.
Methodology: This cross sectional study was conducted at department of Surgery, Nishtar medical university/hospital, Multan from 1st November, 2019 to 30th April, 2021. Blood samples from patients were collected after admission, for CRP, TLC and Neutrophil percentage. Data were collected and analyzed through SPSS version 23.
Results: A total of 320 patients more than 12 years of age, 168 (52.5%) male and 152 (47.5%) female with 1.10:1, were included in the study. Sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) of CRP were 90.6%, 80%, 96% and 61.5% for acute appendicitis and 96.7%, 80%, 98.3%, and 66.7% for perforated appendicitis respectively with p-value of <0.000. Sensitivity, specificity, PPV and NPV of TLC were 87.5%, 80%, 95.9% and 54.5% for acute and 93.3%, 90%, 99.1% and 52.9% for perforated appendicitis with p= <0.000. Sensitivity, specificity, PPV and NPV of Neutrophils, in acute and perforated appendicitis were 83.8%, 76.7%, 95%, and 46.9% versus 87.5%, 70%, 97.2%, 31.8% respectively with P-value < 0.000.
Conclusion: Sensitivity, specificity and PPV of CRP, TLC and Neutrophils increased with the severity of appendicitis. Combining the results of the above three markers increased the diagnostic accuracy.
Keywords: Acute appendicitis, CRP (C-reactive protein), TLC (Leukocyte count) and Neutrophils.
背景:许多临床方法、评分系统、放射学和实验室检查用于诊断和区分单纯性和复杂性阑尾炎。主动入路阴性阑尾发生率高,保守入路术后并发症发生率增高。本研究的目的是评价CRP、TLC和中性粒细胞百分比在单纯性和复杂性阑尾炎的诊断和鉴别中的作用。方法:本横断面研究于2019年11月1日至2021年4月30日在木尔坦尼什塔尔医科大学/医院外科进行。入院后采集患者血液,检测CRP、TLC、中性粒细胞百分比。数据的收集和分析采用SPSS version 23。结果:共纳入320例12岁以上患者,其中男性168例(52.5%),女性152例(47.5%),男女比例为1.10:1。急性阑尾炎CRP的敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)分别为90.6%、80%、96%、61.5%,穿孔阑尾炎CRP的敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)分别为96.7%、80%、98.3%、66.7%,p值均<0.000。TLC对急性阑尾炎的敏感性、特异性、PPV和NPV分别为87.5%、80%、95.9%和54.5%,对穿孔性阑尾炎的敏感性、特异性和PPV分别为93.3%、90%、99.1%和52.9%,p= <0.000。中性粒细胞在急性阑尾炎和穿孔阑尾炎中的敏感性、特异性、PPV和NPV分别为83.8%、76.7%、95%和46.9%,而p值分别为87.5%、70%、97.2%、31.8%。结论:随着阑尾炎的加重,CRP、TLC和中性粒细胞的敏感性、特异性和PPV均增高。结合以上三个指标的结果,提高了诊断的准确性。关键词:急性阑尾炎,c反应蛋白,白细胞计数,中性粒细胞。