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Diagnostic accuracy of white cell count and C-reactive protein for assessing the severity of paediatric appendicitis

Khurram Siddique1, Paramita Baruah, Santosh Bhandari

  • 1Department of General Surgery , William Harvey Hospital, Ashford, Kent , UK.

JRSM Short Reports
|August 18, 2011
PubMed

Insights

White cell count (WCC) and C-reactive protein (CRP) aid in diagnosing paediatric appendicitis severity. Combined, WCC and CRP offer high accuracy for simple and perforated appendicitis in children.

Area of Science:

  • Pediatric Surgery
  • Diagnostic Imaging
  • Clinical Pathology

Background:

  • Acute appendicitis is a common surgical emergency in children.
  • Accurate diagnosis is crucial to prevent complications.
  • Biomarkers like white cell count (WCC) and C-reactive protein (CRP) are used to aid diagnosis.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of WCC and CRP for assessing the severity of acute appendicitis in children.
  • To compare the diagnostic performance of WCC and CRP individually and in combination.

Main Methods:

  • A cross-sectional study was conducted on children undergoing open appendectomy.
  • Data on demographics, WCC, CRP, histology, and complications were analyzed.
  • Diagnostic accuracy of WCC and CRP for simple appendicitis and perforated appendix was assessed.

Main Results:

  • Out of 204 patients, 32 had perforated appendix; this group had significantly worse clinical parameters (P<0.05).
  • White cell count (WCC) demonstrated higher diagnostic accuracy and sensitivity than C-reactive protein (CRP) for simple appendicitis.
  • Combined WCC and CRP sensitivity reached 95% for simple appendicitis and 100% for perforated appendicitis.

Conclusions:

  • WCC is more accurate than CRP in diagnosing simple acute appendicitis.
  • The combination of WCC and CRP significantly enhances diagnostic accuracy for both simple and perforated appendicitis in pediatric patients.
Abstract

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