C-reactive protein and total serum bilirubin as a predictor of perforated appendicitis: a cross sectional study

Anil Reddy Pinate; Shivakumar C. R.; Mohammad Fazelul Rahman Shoeb; Sharangouda Patil

doi:10.18203/2349-2902.isj20182776

Authors

Anil Reddy Pinate Department of General Surgery, Gulbarga Institute of Medical Sciences, Gulbarga, Karnataka, India
Shivakumar C. R. Department of General Surgery, Gulbarga Institute of Medical Sciences, Gulbarga, Karnataka, India
Mohammad Fazelul Rahman Shoeb Department of General Surgery, Gulbarga Institute of Medical Sciences, Gulbarga, Karnataka, India
Sharangouda Patil Department of General Surgery, Gulbarga Institute of Medical Sciences, Gulbarga, Karnataka, India

DOI:

https://doi.org/10.18203/2349-2902.isj20182776

Keywords:

Appendicitis, C-reactive protein, Perforated appendicitis, Total serum bilirubin

Abstract

Background: C-reactive protein (CRP) and bilirubin have been used as adjuncts for diagnosis of appendicitis. This study assessed the diagnostic value of these markers in patients with suspected acute appendicitis.

Methods: CRP values and total serum bilirubin among the patients who presented with acute appendicitis were compared among patients who had perforated appendix and non- perforated appendix. The diagnostic value of CRP and TSB markers as a predictor for perforation were compared in terms of Sensitivity, specificity, PPVs and NPV and the diagnostic accuracy assessed by AUC using receiver operating characteristic (ROC) curve analysis.

Results: This study showed sensitivity is 72.50%, specificity of 92.23%, positive predictive value of 78.38% for a raised CRP. The sensitivity of TSB for predicting perforation is 77.50 and the values of specificity, PPV and NPV of the same are 87.38 %, 70.45% and 90.91% respectively. The area under curve was more for CRP than TSB indicating that CRP is better predictor for perforation in appendicitis as compared to the TSB.

Conclusions: Thus, serum CRP and total serum bilirubin (TSB) can be used as useful markers for early diagnosis and prediction of perforation in cases of acute appendicitis.

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