An Evaluated Preoperative C-Reactive Protein Level as a Predictor of Difficult Laparoscopic Appendectomy

Area of Science:

• General Surgery
• Surgical Diagnostics

Background:

• Appendicitis is a common surgical emergency.
• Laparoscopic appendectomy (LA) is a standard treatment.
• Predicting surgical difficulty preoperatively is crucial for patient management.

Purpose of the Study:

• To assess the diagnostic accuracy of elevated preoperative C-reactive protein (CRP) levels in predicting difficult laparoscopic appendectomy (LA).

Main Methods:

• A descriptive study was conducted involving 181 patients undergoing LA.
• Serum CRP levels were measured preoperatively.
• Diagnostic accuracy metrics including sensitivity, specificity, PPV, NPV, and AUROC were calculated.

Main Results:

• A CRP cut-off of 220 mg/L effectively predicted difficult LA.
• The sensitivity, specificity, PPV, and NPV for CRP ≥220 mg/L were 87.37%, 90.01%, 86.96%, and 93.26%, respectively.
• The AUROC was 0.941, indicating high predictive accuracy.

Conclusions:

• Preoperative elevated CRP levels are a significant predictor of difficult laparoscopic appendectomy.
• CRP measurement can assist in patient selection for early discharge and reduce unnecessary investigations.