Predictive value of C-reactive protein with Alvarado score in acute appendicitis.

Abstract

BACKGROUND:

The aim of the study was to evaluate whether C-reactive protein (CRP) level on admission could aid the diagnostic accuracy of Alvarado score in acute appendicitis.

METHODS:

We retrospectively evaluated hospital records and database of 234 patients (men 116, women 118, median age 28 years, range 15-87 years) who underwent appendicectomy for acute appendicitis. Patients were categorized into three groups retrospectively based on the Alvarado score. Group I: score 7-10 (n = 155), group II: score 4-6 (n = 71), group III: score less than 3 (n = 10). Negative (NPV) and positive predictive values (PPV) of CRP was calculated.

RESULTS:

Overall, 169 of 234 (72.2%) had histopathological confirmation of acute appendicitis. The predicted accuracy of Alvarado score was 84.5% in group I, 50.7% in group II and 25% in group III. The PPV of high CRP and NPV of normal CRP for group I was 88% and 36.4%, in group II, 63% and 72%, in group III, 33% and 86%, respectively.

CONCLUSION:

The Alvarado score and CRP taken together improve the predictive value of diagnosing acute appendicitis. Having a normal CRP in the equivocal group of Alvarado 4-6, should be further evaluated by advanced imaging before proceeding to appendicectomy.

• Authors: Siva Thirumallai, Suraj Ruwan Wijesuriya, Andrew Mitchell, Luc Delriviere
• Journal: ANZ journal of surgery (ANZ J Surg) Vol. 84 Issue 5 Pg. 335-6 (May 2014) ISSN: 1445-2197 [Electronic] Australia
• PMID: 24119072 (Publication Type: Journal Article)
• Copyright: © 2013 Royal Australasian College of Surgeons.

Chemical References

• C-Reactive Protein

Topics

• Acute Disease
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Appendicitis (diagnosis)
• C-Reactive Protein (analysis)
• Female
• Humans
• Male
• Middle Aged
• Predictive Value of Tests
• Research Design
• Retrospective Studies