Diagnostic value of procalcitonin, C-reactive protein, and erythrocyte sedimentation rate for acute complicated appendicitis

Aim: Acute appendicitis (AA) is one of the most common surgical emergencies. Despite extraordinary advances in modern investigations, an accurate diagnosis of AA remains an enigmatic challenge. The purpose of this study was to examine the laboratory parameters studied during the preoperative period in patients who were histopathologically diagnosed with AA; C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) in the differential diagnosis of complicated/uncomplicated appendicitis. Material and Method: This study included 106 patients, separated into two main groups; the uncomplicated appendicitis group (n = 74) and complicated appendicitis group (n = 32). The CRP, ESR, and PCT levels were calculated for all of the patients in the study. Results: No meaningful differences were observed among the groups, with regards to the sex of the patients. There was, however, a significant difference obtained between the (P>0.05) CRP, ESR, and PCT values. Serum levels of ESR >31 (AUC = 0.706, P = 0.001, 95% GA: 0.610-0.791), in PCT>1.8 (AUC = 0.709, P = 0.001, 95% GA: 0.568-0.754), and CRP>56.64 (AUC = 0.700, P < 0.001, 95% GA: 0.603-0.785) were obtained. In both complicated appendicitis and uncomplicated appendicitis analyses, these values were found to be accurate. Using the cut-off values obtained in this study, the ESR, CRP, and PCT serum values, and odds ratios were calculated for complicated appendicitis by classification (odds ratio: 1.042 (0.990-1.097), 1.009 (0.998-1.020), and 2.986 (1.135-7.858), respectively. Discussion: We suggest that with a PCT level>1.8, CRP level>56.64, and ESR level >31, immediate and careful management must be undertaken, as the probability of complicated appendicitis is high.