Accuracy of C-Reactive Protein and Procalcitonin in Differentiating between Complicated and Non-complicated Acute Appendicitis Patients in Babylon Province

Abstract

Background: Clinical care may be influenced by the ability to predict whether a patient has complicated appendicitis at the time of presentation. However, it is unclear whether prehospital or in-hospital factors are associated with complicated appendicitis. We also want to know if C-reactive protein (CRP) and procalcitonin (PCT) can be used as supporting factors for Alvarado Score associated with complex appendicitis. Objectives: The aim of this study is to know the possibility of adding CRP and PCT to support the diagnostic protocol for differentiating between complicated acute appendicitis and noncomplicated acute appendicitis by knowing the sensitivity and specificity of each of them, as well as knowing which is more acceptable to add to the diagnostic protocol. Materials and Methods: A cross-sectional study was carried out in the Emergency Unit at AL-Hilla Teaching Hospital in Babylon province, Hilla city, between October 2021 and January 2022. There were a total of 90 patients; CRP and PCT were measured for patients by enzyme-linked immunosorbent assay method, in addition to knowing their Alvarado score. SPSS software was used to conduct the statistical analysis. Results: At the time of surgery, 34 (40%) of the 90 patients had complicated appendicitis, whereas 54 (60%) without complication. The age and gender of the groups did not show any significant difference. The Alvarado score, CRP, and PCT levels all showed a significant difference (P < 0.05). The correlation between Alvarado score and biochemical parameters (CRP and PCT) show a significant positive correlation. Conclusions: CRP and PCT support Alvarado score to differentiate between complicated acute appendicitis and noncomplicated acute appendicitis, and this is evident from the significantly higher concentrations of both in patients with complicated acute appendicitis than in patients with noncomplicated acute appendicitis.