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Predictive value of white blood cell count and C-reactive protein in children with appendicitis
Marcelo A Beltrán1, Jorge Almonacid, Alfonso Vicencio
1Department of Surgery and Emergency Unit, Hospital de Ovalle, Ovalle IV Region, Chile. beltran_01@yahoo.com
Insights
White blood cell (WBC) and C-reactive protein (CRP) levels effectively diagnose appendicitis. Their predictive value varies with symptom onset time, aiding differentiation between simple and perforated cases.
Area of Science:
- Medical Diagnostics
- Clinical Pathology
- Surgical Gastroenterology
Background:
- Limited research exists on the predictive value of white blood cells (WBC) and C-reactive protein (CRP) at various cutoff points for appendicitis.
- Understanding these markers' utility across different clinical stages is crucial for accurate diagnosis and management.
Purpose of the Study:
- To determine optimal cutoff values for WBC and CRP during appendicitis evolution.
- To establish the diagnostic and discriminative utility of these markers for appendicitis and its severity (simple vs. perforated).
Main Methods:
- A study involving 198 patients operated on for appendicitis.
- Patients were categorized into four subgroups based on symptom onset to diagnosis time.
- Receiver operating characteristic (ROC) curves were used to identify best cutoff points for WBC and CRP, assessing sensitivity and specificity.
Main Results:
- Both WBC and CRP demonstrated high sensitivity individually and combined for diagnosing appendicitis.
- While specificity was high for differentiating simple from perforated appendicitis, sensitivity was low for this distinction.
Conclusions:
- WBC and CRP can support the clinical diagnosis of appendicitis.
- Their utility in differentiating appendicitis and distinguishing simple from perforated cases is dependent on the time elapsed since symptom onset.
Background/Purpose:
Few studies have addressed the predictive value of white blood cells (WBCs) and C-reactive protein (CRP) at different cutoff values in appendicitis. Our purpose was to determine the cutoff values for WBC and CRP at different periods during clinical evolution of appendicitis and to establish their use for the diagnosis of appendicitis and differentiation of simple from perforated appendicitis.
Methods:
We studied 198 patients operated on for appendicitis, which were further divided into 4 subgroups according to the time from the onset of symptoms to diagnosis. Receiver operating characteristic curves were constructed for CRP and WBC; the best cutoff points were used to calculate the sensitivity and specificity to discriminate patients with and without appendicitis and patients with simple and perforated appendicitis.
Results:
White blood cell and CRP individually and together had a high sensitivity to differentiate patients with and without appendicitis. The specificity of WBC and CRP taken individually and together to differentiate patients with simple and perforated appendicitis was high, but the sensitivity was low.
Conclusions:
White blood cell and CRP could be used to support the clinical diagnosis of appendicitis, and, depending on the time from the onset of symptoms to diagnosis, to differentiate patients with and without appendicitis and discriminate simple from perforated appendicitis.
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