Diagnostic Value of Total Leucocyte Count and C-reactive protein in Acute Appendicitis

Aim: To determine the value of pre-operative total leucocyte count (TLC) and C-reactive protein (CRP) in diagnosis of acute appendicitis. Methods: We carried out this study in general surgical unit of King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia. All patients aged 12 and above undergoing appendectomy from May 2013 to February 2014 were studied. Incidental appendectomies were excluded. All patients were analyzed in regards to pre-operative TLC, CRP and final histology. Results: Total of 100 patients were diagnosed as acute appendicitis and underwent emergency appendectomy. TLC and CRP were performed for all the patients pre-operatively. TLC had a sensitivity of 72.41% and specificity of 69.23% where as CRP showed 78.16% sensitivity and 61.53% specificity. Positive predictive value (PPV) was 94.02% for TLC and 93.15% for CRP. Negative predictive value (NPV) was 27.27% for TLC and 26.92% for CRP. Combined TLC and CRP showed sensitivity of 89.28%, specificity of 83.33%, PPV of 98.03% and NPV of 45.45%. Conclusion: We concluded that TLC and CRP are better predictors of presence or absence of acute appendicitis when both are considered together rather than individually.