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Pediatric perforated appendicitis diagnosis based on the C-reactive protein/prealbumin ratio

Junshan Long1, Jing Zhang1, Gong Chen2

  • 1Department of General Surgery, Hainan Women and Children's Medical Center, Changbin Road, Haikou, Hainan, China.

Scientific Reports
|March 21, 2024
PubMed

Insights

The C-reactive protein to prealbumin ratio (CPA) effectively predicts perforated appendicitis in children. Elevated CPA levels indicate a higher risk of perforation, aiding early diagnosis and treatment in pediatric cases.

Area of Science:

  • Pediatric Surgery
  • Biomarkers
  • Clinical Diagnostics

Background:

  • Pediatric perforated appendicitis presents significant complications.
  • Early diagnosis and intervention are crucial for better outcomes.
  • Identifying reliable serum biomarkers is essential for timely detection.

Purpose of the Study:

  • To evaluate the C-reactive protein to prealbumin ratio (CPA) as a potential biomarker for perforated appendicitis in children.
  • To determine the diagnostic accuracy of CPA in different pediatric age groups.

Main Methods:

  • A cross-sectional study included 313 pediatric patients with acute appendicitis.
  • Patients were divided into perforated and non-perforated groups.
  • The CPA levels were analyzed, and ROC curves were generated to assess diagnostic performance.

Main Results:

  • A significant difference in CPA levels was observed between perforated and non-perforated groups (p < 0.001).
  • In children aged 4-9, CPA > 3 showed 76.2% sensitivity and 81.6% specificity (AUC 0.816).
  • In children aged 9-16, CPA > 2.2 demonstrated 85% sensitivity and 85.7% specificity (AUC 0.919).

Conclusions:

  • The C-reactive protein to prealbumin ratio (CPA) is a promising biomarker for diagnosing perforated appendicitis in pediatric patients.
  • Specific CPA thresholds can predict perforation risk in different age groups (4-9 and 9-16 years).
  • CPA offers a valuable tool for early detection and management of complicated appendicitis in children.

Keywords:
BiomarkerC-reactive proteinEarly interventionOdds ratioPediatricPerforated appendicitisPrealbuminPredictor

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