Can common serum biomarkers predict complicated appendicitis in children?

Area of Science:

• Pediatric Surgery
• Biomarkers in Medicine
• Gastrointestinal Diseases

Background:

• Appendicitis management in children varies with disease severity.
• Accurate diagnosis is crucial for appropriate treatment.
• Distinguishing simple from complicated appendicitis impacts surgical decisions.

Purpose of the Study:

• To evaluate if common serum biomarkers on admission can differentiate between simple and complicated appendicitis in children.
• To assess the utility of white blood cell (WBC), neutrophil (NEU), and C-reactive protein (CRP) levels.

Main Methods:

• Analysis of admission WBC, NEU, and CRP levels in 1197 children.
• Patients categorized by age and appendicitis histology (normal, simple, complicated).
• Statistical analysis included ROC curves, Kruskal-Wallis, and contingency tests.

Main Results:

• Complicated appendicitis (CA) cases showed significantly higher CRP and WBC levels than normal appendix (NA) and simple appendicitis (SA) cases (p < 0.0001).
• NEU levels were lower in NA compared to SA or CA (p < 0.0001) but similar between SA and CA.
• Higher CRP (>40 mg/L) and WBC (>15 × 10^9/L) levels were more frequent in CA patients than SA patients, particularly in children aged 5-17.

Conclusions:

• Admission CRP and WBC levels are valuable predictors of complicated appendicitis in children over five years old.
• These biomarkers can assist clinicians in preoperative decision-making for appendicitis severity.
• Early differentiation of appendicitis severity using serum biomarkers can guide treatment strategies.