sTREM-1 assessment as a diagnostic biomarker for suspected acute appendicitis in children

2019 ◽  
Author(s):  
Tal Taraboulos Klein ◽  
Elkana Kohn ◽  
Baruch Klin ◽  
Tomer Ziv-Baran ◽  
Eran Kozer ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Complete Blood Count ◽  
Surrogate Marker ◽  
Serum Levels ◽  
Alvarado Score ◽  
Suspected Appendicitis ◽  
Reactive Protein ◽  
Significant Difference ◽  
History Of ◽  
Suspected Acute Appendicitis

Abstract Background The typical history of acute appendicitis is observed in less than 60% of cases. Therefore, searching for a surrogate marker is mandatory. Our goal was to determine whether the soluble triggering receptor expressed on myeloid cells (sTREM-1) is an efficient biomarker for acute appendicitis. Methods sTREM-1 serum levels were measured in addition to carrying out routine diagnostic tests (urine dipstick, complete blood count and C- reactive protein) in children admitted to the Emergency Department with suspected appendicitis. Statistical analysis was performed in order to examine whether sTREM-1 was a significant predictor of appendicitis. Results Fifty three of 134 children enrolled in the study were diagnosed with appendicitis. There was no significant difference in serum sTREM-1 levels (p=0.111) between children with or without appendicitis. Leukocytes, neutrophils and CRP were significantly elevated in the appendicitis group (p<0.001). The appendix diameter was significantly larger and the Alvarado score significantly higher in the appendicitis group (p<0.001). Conclusion serum sTREM-1 is not a good marker for acute appendicitis. Customary tests in addition to a proper patient history and physical examination are still the most effective methods to diagnose acute appendicitis.

scholarly journals Diagnostic accuracy of combining C-Reactive protein and Alvarado Score among 2-to-20-year-old patients with acute appendicitis suspected presenting to Emergency Departments

2021 ◽  
Author(s):  
Kinda Altali Alhames ◽  
Francisco Javier Martín-Sánchez ◽  
Pedro Ruiz-Artacho ◽  
Francisco Javier Ayuso ◽  
Victoria Trenchs ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Emergency Departments ◽  
Low Risk ◽  
C Reactive Protein ◽  
Alvarado Score ◽  
Old Patients ◽  
Reactive Protein ◽  
Surgical Data ◽  
Suspected Acute Appendicitis

Objective. Main objective was whether the combination of C-Reactive Protein (CRP) and Alvarado Score (AS) increase the diagnosis accuracy of AS among 2-to-20-year-old patients with suspected acute appendicitis presenting to Emergency Departments. Materials and methods. This is a secondary analysis of prospective cohort study consecutively including all patients from 2 to 20 years of age attended for suspected acute appendicitis in 4 Spanish Emergency Departments during 6-month period. We collected demographic, clinical, analytic and radiographic, and surgical data. AS categories were retrospectively calculated as low (0-4 points), intermediate (5-6 points) or high (7-10 points). The cut-off levels were >0.5 mg/dl for CRP. The outcome was diagnosis of acute appendicitis within 14 days of the index visit. Results. A total of 331 patients with suspected of acute appendicitis (mean age 11.8 (SD 3.8) years; 52.9% males) were recruited. According to AS, 108 (32.6%) were at low risk, 76 at (23.0%) intermediate risk and 147 (44.4%) at high risk of acute appendicitis. One hundred and sixteen (35.0%) cases had confirmed histopathological diagnosis of acute appendicitis. The AUCs of ROC were 0.76 (0.70-0.81) for AS and 0.79 (95% CI 0.75-0.84) for CRP-AS being the difference statistically significant (p=0.003). The CRP for diagnosis acute appendicitis in low risk AS group had negative predictive value of 95.8% (95%CI 87.3-98.9) and likelihood ratio negative of 0.4 (95%CI 0.2-1.0). Conclusions. CRP-AS has shown to increase the diagnostic accuracy of AS for acute appendicitis. This approach may be useful to rule out the diagnosis of acute appendicitis in paediatric patients attended for abdominal pain suggestive of acute appendicitis.

scholarly journals A three year prospective study-suspected acute appendicitis: diagnostic accuracy of modified Alvarado score versus ultrasonography in adults

2017 ◽  
Vol 4 (12) ◽  
pp. 3924
Author(s):  
Murhari D. Gaikwad ◽  
Anand Auti ◽  
Avinash Magare
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Prospective Study ◽  
Predictive Value ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Alvarado Score ◽  
Suspected Appendicitis ◽  
Modified Alvarado Score ◽  
Suspected Acute Appendicitis

Background: To evaluate and compare diagnostic accuracy of modified Alvarado score and ultrasonography in co-relation to histopathology report for diagnosis of acute appendicitis.Methods: A prospective study of the patients who underwent appendectomy for suspected acute appendicitis at IIMS and R Medical College and Noor Hospital Warudi, Badnapur, Dist. Jalna (Maharashtra). The clinical (radiological) and ultrasonography data of 760 patients with suspected appendicitis was collected between March 2014 to Feb. 2017. These patients were evaluated by modified Alvarado score and ultrasonographically, which was corrected with histopathological finding.Results: Out of 760 patients 69.34% had acute appendicitis 63.81% had modified Alvarado score≥7 and 58.28% patients were ultrasonographically positive. In present study modified Alvarado score has sensitivity of 89.37% specificity 93.99% positive predictive value 97.11%, negative predictive value 79.64%, diagnostic accuracy of 81.32%.Conclusions: Modified Alvarado score can be used effectively in clinical decision making. When compare with ultrasonography neither one is advantageous. However, additional information provided by ultrasonography improves diagnostic accuracy.

EVALUATION OF THE PERTINENCE OF MODIFIED ALVARADO SCORE IN THE DIAGNOSIS OF SUSPECTED ACUTE APPENDICITIS

2021 ◽  
pp. 68-70
Author(s):  
Debasish Ray ◽  
Nipun Roy ◽  
Subikash Biswas ◽  
Ashim Mandal ◽  
Debarshi Jana
Keyword(s):  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Surgical Removal ◽  
Lower Abdomen ◽  
Alvarado Score ◽  
Suspected Appendicitis ◽  
Surgical Emergencies ◽  
Grade 3 ◽  
Modified Alvarado Score ◽  
Suspected Acute Appendicitis

INTRODUCTION:Appendicitis remains one of the most common surgical emergencies faced by surgeons during his surgical practice. The rst formal description of Acute Appendicitis as a disease entity and its natural process, along with common clinical features and recommendation for its prompt surgical removal was done by Reginald Heber Fitz in 1886 in Harvard University1.AIMS AND OBJECTIVES: This study is aimed to evaluate the pertinence of modied Alvarado score in the diagnosis of suspected acute appendicitis. To look for the effectiveness of Modied Alvarado Score in clinical practice for diagnosis of acute appendicitis by correlating the score with operative and histopathological ndings. MATERIALS AND METHODS:Patients admitted in the inpatient department with pain right lower abdomen especially right iliac fossa tenderness, suspected appendicitis in the department of General Surgery, College of Medicine& JNM Hospital, Kalyani. 6 MONTHS from the period of institutional ethical committee clearance. RESULTS: A MODIFIED ALVARADO SCORE of 6 has been obtained in most of the participants (26.87%), followed by higher Modied Alvarado Score scores of 7, 8 and 9 in 25%, 18.75% and 17.5% respectively. Only about 11.88% participants have a score less than 6.Most of the participants, a little less than two-third of them had a MODIFIED ALVARADO SCORE grade 3, almost one-third had a grade 2 and only 5.6% belonged to grade 1 group.

scholarly journals Predictive values of Alvarado score, serum C-reactive protein, and white blood cell count in the diagnosis of acute appendicitis: a prospective study

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Ademola Olusegun Talabi ◽  
Tewogbade Adeoye Adedeji ◽  
Oludayo Adedapo Sowande ◽  
Olusanya Adejuyigbe
Keyword(s):  
Acute Appendicitis ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
C Reactive Protein ◽  
Blood Cell Count ◽  
Alvarado Score ◽  
Reactive Protein ◽  
Wbc Count

Abstract Background The diagnosis of acute appendicitis in children is quite challenging as the rate of negative appendectomy varies between 15 and 57%. Increased utilization of imaging diagnostic facilities in advanced countries seems to have reduced the incidence of operating on normal appendix to a single digit. In low- and middle-income countries, the incidence remains unacceptably high (double digits). Inflammatory markers and scoring systems may be a suitable adjunct to increase diagnostic yield in most third world countries. Thus, the aim of this study was to evaluate the diagnostic value of Alvarado score, white blood cell count, and serum C-reactive protein in children with acute appendicitis. Results The ages of patients ranged between 4 and 15 years with a mean of 11.2 ± 2.8 years. The male to female ratio was 1.4 to 1.0. Nineteen percent of patients had negative appendiceal findings on histological examination. The sensitivity and specificity of Alvarado score, C-reactive protein estimation, total white blood cell count in diagnosing acute appendicitis were 86.4% and 63.2%, 98.8% and 36.8%, and 51.9% and 89.5% respectively. Alvarado score has the highest area under ROC curve analysis 0.824, 95% CI of 0.724 to 0.924 compared with CRP, 0.769. 95% CI of = 0.647 to 0.891 and WBC count, 0.765, 95% CI of 0.643 to 0.887. Both CRP and WBC count showed higher discriminatory values between complicated and uncomplicated appendicitis, p < 0.001. Conclusion Alvarado score outperformed other tests in setting the diagnosis of acute appendicitis. However, none of the tests can be relied on wholly for operative decision. Clinical judgement remains the bedrock for diagnosis and operative management.

EP.FRI.615 Assessing the reliability of the Adult Appendicitis Score in managing patients with suspected acute appendicitis

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Carry Zheng ◽  
Shiela Lee ◽  
Steven Brown ◽  
Venkat Kanakala
Keyword(s):  
Acute Appendicitis ◽  
Risk Group ◽  
Pathological Finding ◽  
High Risk Group ◽  
Histological Diagnosis ◽  
Suspected Appendicitis ◽  
Tertiary Centre ◽  
Negative Appendicectomy ◽  
Age Range ◽  
Suspected Acute Appendicitis

Abstract Aims To evaluate the effectiveness of using a clinical prediction tool in the management of suspected acute appendicitis Methods Retrospective data was collected on patients undergoing appendicectomy at a single tertiary centre from November 2019 to June 2020. Inclusion criteria were all patients aged 18 and above undergoing diagnostic laparoscopy for suspected appendicitis. Exclusion criteria were all patients that had a pathological finding other than appendicitis at laparoscopy. The pre operative AAS score at first presentation was calculated and patients grouped into low(0-10), intermediate(11-15), and high(16 and above) risk. These groups were then compared to the histological findings. Results A total of 74 patients were included, 44 male and 30 female. The age range was from 18 to 83, with a median age of 36. Of 10 patients in the low risk group, 4 (40%) had appendicitis on histology. 36 out of 40 (90%) patients in the intermediate risk group had appendicitis and 100% of the 24 patients in the high risk group. Pearson’s coefficient showed a significant correlation between the AAS risk (low, intermediate, and high) and the histological diagnosis of appendicitis (r = 0.48, p = 0.000016). Conclusions Our study did show a positive correlation between the AAS risk stratification and histological diagnosis. Based on our findings we would recommend the adoption of this score in assessing patients with suspected acute appendicitis and minimising the negative appendicectomy rate.

Prospective study of computed tomography in patients with suspected acute appendicitis and low Alvarado score

2012 ◽  
Vol 30 (8) ◽  
pp. 1597-1601 ◽  
Author(s):  
Shang-Yu Wang ◽  
Jen-Feng Fang ◽  
Chien-Hung Liao ◽  
I-Ming Kuo ◽  
Chun-Hsiang Ou Yang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Prospective Study ◽  
Alvarado Score ◽  
Suspected Acute Appendicitis

scholarly journals Is Systemic Inflammation Associated With Elevated PSA Serum Levels In Patients Submitted Chronic Hemodialysis?

10.3823/2522 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Gilmar Pereira Silva ◽  
Vitor Pereira Xavier Grangeiro
Keyword(s):  
Systemic Inflammation ◽  
Serum Levels ◽  
Chronic Hemodialysis ◽  
Control Group ◽  
Inclusion Criteria ◽  
Reactive Protein ◽  
Free Psa ◽  
Significant Difference ◽  
Level Elevation ◽  
Hs Crp

Backgroundː whereas that systemic inflammation (SI) affects 40–60% of patients on hemodialysis (HD) is characterized by serum C-reactive protein (CRP) level elevation or proinflammatory interleukin production or both. We evaluated the association between SI and total (tPSA) and free PSA (fPSA) in patients on HD with tPSA <4ng / ml. Methodsː Sixty patients with chronic kidney disease (CKD) undergoing HD and 20 controls were included. Inclusion criteria were patients aged 18-60 years; tPSA < 4 ng/mL without clinically detectable prostate cancer; and patients undergoing HD for >6 months. Patients were excluded if they had local infections or SI. Hs-CRP was measured using turbidimetry, and tPSA and fPSA levels using immunochemoluminescence. Overall, 27 patients had inflammation (hs-CRP >5 mg/L) and 33 had no inflammation (hs-CRP was ≤5 mg/L). In the control group, hs-CRP was ≤ 1 mg/L. Resultsː there was no significant difference in mean levels among groups 3 and 4 for age (p=0,058), tPSA (p=0,74) and fPSA (p=0,30). The SI did not promote differences between groups 1, 2 and 4 for the levels of tPSA (0,71 ± 0,18  vs   0,67 ± 0,15  vs  0,67 ± 0,11; p=0,69) and fPSA (0,34  ±  0,01  vs  0,34  ±  0,01  vs   0,35  ±  0,01, p= 0,59) . As well as maintained no correlation with tPSA and fPSA (p>0,05). Conclusionː The systemic inflammation in hemodialytic patients without clinically detectable cancer (PSA<4ng/ml) is no associated with changes fractions of tPSA and fPSA.

scholarly journals Comparison of Cardiometabolic Biomarkers in Two Groups of US Adults Using Multiple Dietary Supplements: A Cross-Sectional Study (P18-116-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Sonhee Park ◽  
Hong Wang ◽  
Bruce Daggy ◽  
Jamie McManus ◽  
Paul Jacques
Keyword(s):  
Dietary Supplements ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Funding Sources ◽  
Informed Consent Form ◽  
Significant Difference ◽  
History Of ◽  
Blood Pressures

Abstract Objectives The aim of the present study is to compare cardiometabolic biomarker levels (MARKERS) from a cohort using multiple (2+) dietary supplements (MDS) manufactured by Shaklee Corporation for 3–5 yr (SHAKLEE) to those from the age-matched MDS users from NHANES 2007–10 (NHANES). Methods Each subject from SHAKLEE [n = 58; mean age: 48 yr (22–79 yr)], using MDS manufactured by Shaklee Corp for 3–5 yr, voluntarily signed the IRB approved informed consent form before the study participation. Body mass index (BMI), systolic and diastolic blood pressures (SBP and DSP) were measured, and approximately 30 mL of 12-h fasting blood sample was collected. Pregnant women and people with a history of cancer were excluded. MARKERS from SHAKLEE were compared to those from NHANES [n = 1952; mean age: 51 yr (22–79 yr)]. MARKERS included total cholesterol (TC), HDL-c, TC/HDL-c ratio, LDL-c, triglycerides (TG), high sensitivity C-Reactive Protein (CRP), glucose, hemoglobin A1c (HbA1c), and Insulin levels in the blood as well as BMI, SBP, and DBP. Statistical analyses were performed using independent samples t-tests, and P < 0.05 was considered significantly different between groups. Results SHAKLEE had significantly lower TC (189 vs. 201 mg/dL), TC/HDL-c ratio (3.1 vs. 4.0), LDL-c (103 vs. 118 mg/dL), TG (81 vs. 131 mg/dL), glucose (93 vs. 107 mg/dL), HbA1c (5.1 vs. 5.7%), insulin (8.3 vs. 13.4 mIU/L), BMI (26.7 vs. 29.0), and SBP (110 vs. 122 mmHg), and higher HDL-c (69 vs. 55 mg/dL) but had higher DBP (76 vs. 71 mmHg) than NHANES. There was no significant difference in CRP although CRP was slightly lower in SHAKLEE than NHANES (2.9 vs. 3.8 mg/L). Conclusions The present study showed that 3–5 yr MDS users from the Shaklee cohort had healthier pattern in cardiometabolic biomarkers than the age-matched MDS users from NHANES 2007–2010. Funding Sources Shaklee Corporation, 4747 Willow Road, Pleasanton, CA 94,588, USA.

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