Evaluating the Role of C-reactive Protein in Reducing the Rate of Negative Appendicectomies
Clement Odion
Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Nigeria.
James Kpolugbo
Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Nigeria.
Andrew E. Dongo
Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Nigeria.
Friday Emeakpor Ogbetere *
Department of Surgery, Faculty of Clinical Sciences, Edo State University, Uzairue, Edo State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Acute appendicitis is a common surgical condition of the abdomen. However, diagnostic difficulties may arise, resulting in high rate of negative appendicectomies.
This study aimed to assess the role of C-reactive protein (CRP) in improving the accuracy of diagnosis of acute appendicitis and thus reducing the rate of negative appendicectomies.
Materials and Method: The study was a cross-sectional, hospital-based study carried out on 66 patients who had appendicectomy following a clinical diagnosis of acute appendicitis. Samples for CRP were collected from all recruited patients preoperatively. Following appendicectomy, the appendix was sent for histology. A proforma was used to collect data. All the statistical analyses were performed using IBM statistics package for social sciences (SPSS) version 21. At 95% confidence level, p-values less than 0.05 were considered significant.
Results: Thirteen (13) of the appendices removed had normal histopathologic examination, giving a negative appendicectomy rate of 19.7%. The diagnostic accuracy, sensitivity, specificity and positive predictive value for preoperative CRP were 80%, 79%, 85% and 95% respectively.
Conclusion: An elevated level of CRP is a useful aid for the diagnosis of acute appendicitis. Deferring surgery in patients with normal CRP would likely decrease the incidence of negative appendicectomies.
Keywords: Acute appendicitis, appendicectomy, negative appendicectomy, C-reactive protein