C-Reactive protein is an independent surgical indication marker for appendicitis: A retrospective study

被引：35

作者：

Yokoyama S. ^{[1
]}

Takifuji K. ^{[1
]}

Hotta T. ^{[1
]}

Matsuda K. ^{[1
]}

Nasu T. ^{[1
]}

Nakamori M. ^{[1
]}

Hirabayashi N. ^{[1
]}

Kinoshita H. ^{[1
]}

Yamaue H. ^{[1
]}

机构：

[1] Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama

来源：

World Journal of Emergency Surgery | / 4卷 / 1期

关键词：

Appendicitis; White Blood Cell Count; Acute Appendicitis; Open Appendectomy; Independent Marker;

D O I：

10.1186/1749-7922-4-36

中图分类号：

学科分类号：

摘要：

Background. This study is an attempt to clarify the role of C-reactive protein (CRP) as a surgical indication marker for appendicitis. Methods. One hundred and fifty patients who underwent appendectomies and had pathologically confirmed appendicitis were reviewed between May 1, 1999 and September 31, 2007. The correlation between preoperative clinical factors and the actual histological severity, and identify surgical indication markers were assessed by univariate and multivariate analyses. Results. Univariate analysis showed that only the CRP level significantly differ between the surgical treatment necessary group (gangrenous appendicitis) and the possible non-surgical treatment group (catarrhalis and phlegmonous appendicitis). Multivariate analysis indicated only the CRP level to be a surgical indication marker for acute appendicitis. The receiver-operating characteristic (ROC) curve indicated that the cutoff value of CRP for surgical indication of appendicitis is 4.95 mg/dl. Conclusion. Only the CRP level is consistent with the severity of appendicitis, and considered to be a surgical indication marker for acute appendicitis. © 2009 Yokoyama et al; licensee BioMed Central Ltd.

引用

共 23 条

[1] Eriksson S., Granstrom L., Randomized controlled trial of appendicectomy versus antibiotic therapy for acute appendicitis, Br J Surg, 82, pp. 166-169, (1995)
[2] Oliak D., Yamini D., Udani V.M., Lewis R.J., Arnell T., Vargas H., Stamos M.J., Initial nonoperative management for periappendiceal abscess, Dis Colon Rectum, 44, pp. 936-941, (2001)
[3] Styrud J., Eriksson S., Nilsson I., Ahlberg G., Haapaniemi S., Neovius G., Rex L., Badume I., Granstrom L., Appendectomy versus antibiotic treatment in acute appendicitis. A prospective multicenter randomized controlled trial, World Journal of Surgery, 30, 6, pp. 1033-1037, (2006)
[4] Brown C.V., Abrishami M., Muller M., Velmahos G.C., Appendiceal abscess: Immediate operation or percutaneous drainage?, Am Surg, 69, pp. 829-832, (2003)
[5] Yamini D., Vargas H., Bongard F., Klein S., Stamos M.J., Perforated appendicitis: Is it truly a surgical urgency?, Am Surg, 64, pp. 970-975, (1998)
[6] Friedell M.L., Perez-Izquierdo M., Is there a role for interval appendectomy in the management of acute appendicitis?, Am Surg, 66, pp. 1158-1162, (2000)
[7] Kaminski A., Liu I.-L.A., Applebaum H., Lee S.L., Haigh P.I., Routine interval appendectomy is not justified after initial nonoperative treatment of acute appendicitis, Archives of Surgery, 140, 9, pp. 897-901, (2005)
[8] Mason R.J., Surgery for appendicitis: Is it necessary?, Surg Infect (Larchmt), 9, pp. 481-488, (2008)
[9] Thimsen D.A., Tong G.K., Gruenberg J.C., Prospective evaluation of C-reactive protein in patients suspected to have acute appendicitis, Am Surg, 55, pp. 466-468, (1989)
[10] Dueholm S., Bagi P., Bud M., Laboratory aid in the diagnosis of acute appendicitis. A blinded, prospective trial concerning diagnostic value of leukocyte count, neutrophil differential count, and C-reactive protein, Dis Colon Rectum, 32, pp. 855-859, (1989)

← 1 2 3 →