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C reactive protein in the diagnosis of acute appendicitis
W P Oosterhuis1, A H Zwinderman, M Teeuwen
1Department of Clinical Chemistry, Drechtsteden Hospital, Dordrecht, The Netherlands.
Objective:
To find out if the C reactive protein concentration is of any value in the diagnosis of acute appendicitis, either alone or in combination with other laboratory tests.
Design:
Open study.
Setting:
Drechtsteden Hospital, Dordrecht, and Spaarne Hospital, Heemstede, The Netherlands.
Subjects:
209 consecutive patients admitted with suspected appendicitis.
Main Outcome Measures:
Correlation of C reactive protein concentration with age, sex, body temperature, duration of abdominal pain, anorexia, nausea, vomiting, white cell count, neutrophil count, erythrocyte sedimentation rate, and histological appearance of the appendix.
Results:
125 patients of the 209 patients had their appendixes removed, and of these 101 had histologically confirmed appendicitis: A C reactive protein concentration of > or = 6 mg/1 alone had a sensitivity of 87% and a specificity of 50%. When the selected variables were subjected to multivariate analysis the most important, in decreasing order, were white blood cell count, female sex, and C reactive protein concentration. Combining the variables was of no additional value.
Conclusion:
measurement of the C reactive protein concentration can increase the accuracy in the diagnosis of acute appendicitis.
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Appendicitis