Evaluation of procalcitonin as a predictor of severity of acute appendicitis

Vikrant Dharwal; Ramesh Bharti; Amar Verma; Rajesh Chaudhary; Ravi Singh Dogra; Raj Kumar

doi:10.18203/2349-2902.isj20202400

Authors

Vikrant Dharwal Department of Surgery, Zonal Hospital Mandi, Himachal Pradesh, India
Ramesh Bharti Department of Surgery, Dr. R. P. Govt. Medical College Kangra at Tanda, Himachal Pradesh, India
Amar Verma Department of Surgery, Dr. R. P. Govt. Medical College Kangra at Tanda, Himachal Pradesh, India
Rajesh Chaudhary Department of Surgery, Civil Hospital Nagrota Bagwan, Kangra, Himachal Pradesh, India
Ravi Singh Dogra Department of Surgery, Civil Hospital Ghumarwin, Himachal Pradesh, India
Raj Kumar Department of Surgery, Civil Hospital Baijnath, Kangra, Himachal Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20202400

Keywords:

Acute appendicitis, Alvarado score, Appendectomy, Procalcitonin

Abstract

Background: Acute appendicitis is the most common surgical emergency worldwide. The treatment of choice is emergency appendectomy. A delayed diagnosis and hence a delayed treatment increases the complication rate. Despite the best efforts negative appendectomy rate is still high since there is no single best test available to reach the diagnosis.

Methods: This was an institutional study conducted at DRPGMC Tanda, comprising of 28 patients and 7 healthy controls. The patients with clinical diagnosis of acute appendicitis were subjected to appendectomy after taking a blood sample for serum procalcitonin and performing an ultrasonogram of abdomen.

Results: We observed that mean levels of procalcitonin (PCT) were significantly higher in patients of acute appendicitis in comparison to healthy controls. The range of PCT levels in group 2 i.e., patients with uncomplicated acute appendicitis were from 0.54 to 0.74 ng/ml with mean value of 0.61 ng/ml, whereas in group 3 i.e. patients with complicated acute appendicitis, the range were from 1.14 to 2.56 ng/ml with mean value of 1.62 ng/ml. PCT levels were significantly higher in group 3 as compared to group 1 and group 2 (p<0.0001). In group 2, mean PCT levels were significantly higher in comparison to group 1 (p<0.0001). Statistical analysis of our data shows a cut-off value of procalcitonin to be 0.203 ng/ml. We observed sensitivity and specificity of PCT to be 96% and 100% respectively.

Conclusions: This study concludes that levels of serum PCT can be used as a laboratory marker for making a diagnosis of acute appendicitis and also for predicting its severity.

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