Diagnostic value of C-reactive protein in the pathological types of acute appendicitis in children / 中国小儿急救医学

ABSTRACT

Objective To clarify diagnostic value of C-reactive protein (CRP) in the pathological types of acute appendicitis in children and the role of CRP as a surgical indication marker for appendicitis.Methods Two hundred and six patients who underwent appendectomies and had pathologically confirmed appendicitis were reviewed between January 2010 and February 2014,and they were divided into gangrenous appendicitis group(n =53) and non-gangrenous appendicitis group(n =153) by postoperative pathological type.The correlation between preoperative clinical factors and the actual histological severity,and identify surgical indication markers were assessed by multivariate analysis and ROC analysis.Results There were significant differences in white blood count(WBC),neutrophils percentage and CRP level between gangrenous appendicitis group and non-gangrenous appendicitis group(P ＜ 0.05).Multivariate analysis showed that the level of CRP should be a risk factor for judging gangrenous appendicitis.It showed that the role of CRP in judging gangrenous appendicitis was superior to the proportion of neutrophils and WBC in the ROC curve.The ROC curve showed that the area under the ROC curve for the CRP level,neutrophils percentage and WBC was 0.931,0.659 and 0.599 respectively,and the optimal cut off value of CRP for surgical indication for classifying cases was around 44.4 mg/L,and the sensitivity was 75.5 ％,specificity was 93.5 ％.Conclusion The level of CRP is useful in identifying the pathological types of acute appendicitis in children,and can be considered to be a surgical indication marker for acute appendicitis in children.