Diagnostic Accuracy of Serum Procalcitonin, Crp, and Wbc Count in Differentiating Uncomplicated Vs Complicated Acute Appendicitis
DOI:
https://doi.org/10.53350/Annalspakmed.2.1.4Keywords:
Appendicitis; Procalcitonin; C-Reactive Protein; Leukocyte Count; Diagnostic Accuracy; Surgical EmergenciesAbstract
Background: Acute appendicitis is a common surgical emergency. The ability to differentiate between uncomplicated and complicated appendicitis early in the disease process is important as complicated appendicitis is associated with perforation, abscess, peritonitis, longer hospital stay, and higher post-operative complications. Preoperative assessment of the severity of appendicitis may be aided by inflammatory markers such as serum procalcitonin, C-reactive protein (CRP), and white blood cell (WBC) count.
Objective: To assess and compare the diagnostic value of serum procalcitonin, CRP, and WBC count in distinguishing uncomplicated acute appendicitis from complicated acute appendicitis.
Methods: This cross-sectional analytical study was performed in the Department of General Surgery between June 2023 and June 2024. We enrolled 100 patients between 15 and 60 years of age with a clinical diagnosis of acute appendicitis who were operated on by consecutive sampling. Serum procalcitonin, CRP, and WBC count were determined preoperatively. Uncomplicated and complicated appendicitis were defined by surgery and histopathology. SPSS version 26.0 was used for the statistical analysis.
Results: Among the 100 patients, 58 (58.0%) had uncomplicated appendicitis and 42 (42.0%) had complicated appendicitis. Patients with complicated appendicitis were older, had longer duration of symptoms, and had more fever, guarding, and rebound tenderness. The average WBC count, CRP, and procalcitonin were significantly elevated in complicated appendicitis (p < 0.001). Serum procalcitonin had the best diagnostic performance (sensitivity, 85.7%; specificity, 87.9%; positive predictive value, 83.7%; negative predictive value, 89.5%; and accuracy, 87.0%). CRP had intermediate diagnostic performance, while WBC count was the least accurate.
Conclusion: Procalcitonin was the most accurate marker to distinguish complicated from uncomplicated acute appendicitis, followed by CRP and WBC count. This can be used in the preoperative period for early risk assessment and surgical planning.
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