Journal
AMERICAN JOURNAL OF SURGERY
Volume 209, Issue 6, Pages 1043-1047Publisher
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjsurg.2014.05.024
Keywords
Appendicitis; Diagnosis; Diagnostic markers; Bilirubin; Hyperbilirubinemia
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BACKGROUND: An adequate medical history combined with clinical examination is usually enough to make the diagnosis of acute appendicitis. The aim of this study was to determine the value of elevated white cell count (WCC), C-reactive protein (CRP), and bilirubin as diagnostic markers of acute appendicitis. METHODS: A retrospective analysis was carried out on consecutive patients who underwent appendicectomy over a 3-year period. All data including patients(age, sex, blood test results, and appendix histology were summarized. Sensitivities, specificities, positive, and negative predictive values of WCC, CRP, and bilirubin were calculated separately or in combination for all patients. RESULTS: A total of 447 patients were included. There is a significant difference in the results between patients with negative and positive appendicitis with regards to CRP (32 vs 73; P < .001), mean total WCC (10.9 vs 14.0; P < .001), and the mean levels of bilirubin (10.9 vs 17.2; P < .001). CONCLUSIONS: The diagnosis of appendicitis remains multifactorial and blood tests may help to guide the surgeon in the decision making. (C) 2015 Elsevier Inc. All rights reserved.
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