Association of Serum C Reactive Protein, White Blood Cell Count, and Neutrophil Percentage with Acute Appendicitis: A Cross Sectional Study

Abstract

Aim: To assess the association of serum C reactive protein, white blood cell count, and neutrophil percentage with acute appendicitis

Study design: Cross sectional study

Place and duration:  This study was conducted at Liaquat University of Medical Health Sciences Jamshoro, Pakistan, from February to 2020 to February 2021.

Methodology: The study included 173 people who had surgery for acute appendicitis. Before surgery, their white blood cell count (WBC), neutrophil percentage (NP), and c reactive protein (CRP) levels were measured. A macroscopic examination was done after the surgery. All of the subjects in this research had an appendectomy and a histological examination. It was assessed whether there was a link between the two factors by comparing the gross description to the histology data.  

Result: There were a total of 173 patients operated on, with an observational accuracy of 87.3 percent compared to 85.5 percent for histopathological accuracy. According to the histology findings, 25 individuals (14.5%) had normal appendices, whereas 148 patients (85.5%) had highly inflammatory, gangrenous, or perforated appendicitis. WBC levels were observed to be altered in 77.5 percent of patients, NP levels in 72.3 percent, and C-reactive protein levels in 76.2 percent. CRP and WBC levels were elevated in 126 (72.8%) of patients with positive appendicitis, although NP levels were higher than 75% in 117 patients with positive appendicitis (67.6 percent). The total sensitivity, specificity, and positive predictive values of the three tests, according to the results, were 95.3 percent, 72.2 percent, and 95.3 percent, respectively.

Conclusion: According to the findings of the study, a high level of CRP was shown to be directly connected to the degree of inflammation. The use of CRP observing improves the accuracy of the diagnosis of acute appendicitis in suspected appendicitis patients. The diagnostic accuracy of CRP is not statistically significantly than the combined diagnostic accuracy of WBC and NP. When these three tests are used together, their accuracy improves dramatically. Elevated serum CRP levels, according to our findings, confirm the surgeon's clinical diagnosis.