Could Unnecessary Appendectomies be Avoided Using Neutrophil Count and CRP as a Diagnostic Criterion? Answering an Every-Day Clinical Question

Kripouri Panagiota, Filippou Georgios, Baltopoulos Ioannis, Triga Argyro, Andromanakos Nikolaos, Filippou Dimitrios

Background: Despite improvements in diagnostic medicine the accuracy diagnosis of acute appendicitis in several cases is yet difficult. Methods: 76 patients were admitted in the hospital for possible acute appendicitis. White blood cells count (WBC) measurement and C-reactive protein (CRP) were assessed in all patients. Of 76 patients, 62 (81%) were operated on by the diagnosis of acute appendicitis, 2 (3%) were operated on without diagnosis of acute appendicitis and served as a control group, and the remainder 12 patients remained under observation, were finally not operated on and served as controls, too. The 64 patients, who were managed by appendicectomy, were divided in four groups proportionally to the operative findings and histopathological reports. Each group’s laboratory tests were investigated for WBC and CRP elevation and sensitivity and specificity of these tests were also estimated .

Results: The sensitivity and specificity of these tests were 69% and 71% for neutrophil count and 87% and 100% for CRP, respectively. Conclusion: Thereby, patients with normal results in all tests (CRP and WBC) together are unlikely to have acute appendicitis, but it is not absolute and that is why should be evaluated with greater caution.

https://doi.org/10.31871/IJNTR.4.2.55