Study of predictive value of serum C- reactive protein in diagnosis of acute appendicitis

Background: Acute appendicitis is a common surgical condition and the most common cause of acute surgical abdomen. Commonly used tests for diagnosis of acute appendicitis were WBC, CRP ESR and procalcitonin (PCT) levels. In present study we correlated the serum levels of CRP with the histopathology of the removed appendix, to study predictive value of serum C- reactive protein in diagnosis of acute appendicitis. Material and Methods:Present study was conducted in patients with possibility of acute appendicitis, underwent appendicectomy. The histopathology report was considered as the final diagnosis. CRP more than 6 mg/dl was considered to be positive. Results: In present study total 88 patients were included. Male to female ratio was 1.4:1, most common age group was 21-30 years (35.23%) followed by 31-40 years (27.27%). Abdominal pain (92.05%), McBurney tenderness (80.68%), vomiting (76.14%), rebound tenderness (67.05%) and fever (55.68%) were common signs and symptoms noted in present study. On histopathology examination, inflammed appendix (51.14%) was most common finding, others were gangrenous appendix (23.86%), perforated appendix (5.68%) and normal appendix (19.32%). In present study diagnostic efficacy of serum CRP was sensitivity (80%), specificity (84.62%), positive predictive value (96.77%), negative predictive value (42.31%), diagnostic accuracy (80.68%). Conclusion. Serum CRP estimation is useful adjunct in diagnosis of acute appendicitis along with clinical diagnosis. Serum CRP value should be interpreted in combination with clinical findings.

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Combined serum and synovial C-reactive protein tests: a valuable adjunct to the diagnosis of chronic prosthetic joint infection

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04545-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Hai Wang ◽

Leilei Qin ◽

Jiawei Wang ◽

Ning Hu ◽

Wei Huang

Keyword(s):

Predictive Value ◽

Joint Infection ◽

Area Under The Curve ◽

Diagnostic Value ◽

C Reactive Protein ◽

Combined Model ◽

Diagnostic Efficacy ◽

Reactive Protein ◽

Valuable Adjunct ◽

Serum Crp

Abstract Background Diagnosis of periprosthetic joint infection (PJI), especially chronic PJI, is very confusing and challenging. The value of C-reactive protein (CRP) in infectious diseases has been recognized, but the diagnostic value of CRP in chronic PJI is unknown. Our aim was to investigate the diagnostic value of synovial CRP in chronic PJI and to explore the role of combined serum and synovial CRP in distinguishing chronic PJI from aseptic failure after knee and hip arthroplasties. Methods We prospectively enrolled patients scheduled to have a revision surgery for chronic PJI or aseptic loosening from January 2019 to December 2020, in which synovial CRP was additionally measured along with routine preoperative diagnostic serum ((ESR, CRP) and synovial (PMN%) biomarkers. The receiver operating characteristic (ROC) curves and area under the curve (AUC) were analyzed for each biomarker to determine diagnostic efficacy. Results There were no statistically significant differences between the infection (n = 39) and aseptic (n = 58) groups, including 61 hips and 36 knees. The synovial CRP levels were significantly higher in the infection group than in the aseptic group (median: 9.93 mg/l vs 3.58 mg/l; p < .001). The optimal cut-off value for detecting chronic PJI of Synovial fluid (SF) CRP was of 7.26 mg/l with a sensitivity of 84.62%, a specificity of 93.10%. The combined model I (Serum CRP > 10.2 mg/l OR SF CRP > 7.26 mg/l) had a negative predictive value (NPV) of 96.67%, and a sensitivity of 97.44%. The combined model II (Serum CRP > 10.2 mg/l AND Synovial CRP > 7.26 mg/l) led to a specificity of 1, and a positive predictive value (PPV) of 1. Conclusions The present study demonstrated that the combination of serum and synovial CRP can be used as an adjunct to the diagnosis of chronic PJI.

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Combined Serum and Synovial C-Reactive Protein Tests: An Economical and Efficient Adjunct to the Diagnosis of Chronic Prosthetic Joint Infection

10.21203/rs.3.rs-257603/v1 ◽

2021 ◽

Author(s):

Hai Wang ◽

Leilei Qin ◽

Jiawei Wang ◽

Ning Hu ◽

Wei Huang

Keyword(s):

Predictive Value ◽

Demographic Data ◽

Joint Infection ◽

Area Under The Curve ◽

Diagnostic Value ◽

C Reactive Protein ◽

Combined Model ◽

Diagnostic Efficacy ◽

Reactive Protein ◽

Serum Crp

Abstract Background Diagnosis of Periprosthetic joint infection (PJI) is very complex and challenging, especially for chronic PJI. The value of C-reactive protein (CRP) in infectious diseases has been recognized, but the diagnostic value of CRP in chronic PJI is unknown. Our objective was to investigate the effectiveness of synovial CRP in chronic PJI and to determine the optimal combination of serum and synovial CRP in distinguishing chronic PJI from aseptic failure after knee and hip arthroplasties. Methods From January 2018 to December 2019, we prospectively included patients scheduled to have a revision surgery for chronic PJI or aseptic loosening of an implant, in which synovial CRP was additionally measured along with routine preoperative diagnostic serum and synovial biomarkers. The receiver operating characteristic (ROC) curves and area under the curve (AUC) were analyzed for each biomarker to determine diagnostic efficacy. Results There were no statistically significant differences in demographic data among the 97 cases we eventually included. the synovial CRP levels were significantly higher in the infection group than in the aseptic group (median: 19 mg/l vs. 9.25 mg/l; p = .001). The optimal cut-off value for detecting chronic PJI of synovial CRP was of 7.26 mg/l with a sensitivity of 84.62%, a specificity of 93.10%. The combined model I (Serum CRP > 10.2 mg/l OR SF CRP > 7.2 6 mg/l) had a negative predictive value (NPV) of 96.67%, and a sensitivity of 97.44%. The combined model II (Serum CRP > 10.2 mg/l AND Synovial CRP > 7.26 mg/l) led to a specificity of 1, and a positive predictive value (PPV) of 1. Conclusion The present study demonstrated that the combination of serum and synovial CRP can be used as an adjunct to the diagnosis of chronic PJI.

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Predictive value of C-reactive protein at different cutoff levels in acute appendicitis

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2004.10.013 ◽

2005 ◽

Vol 23 (4) ◽

pp. 449-453 ◽

Cited By ~ 44

Author(s):

Han-Ping Wu ◽

Ching-Yuang Lin ◽

Chin-Fu Chang ◽

Yu-Jun Chang ◽

Chin-Yi Huang

Keyword(s):

Acute Appendicitis ◽

Predictive Value ◽

C Reactive Protein ◽

Reactive Protein ◽

Cutoff Levels

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A study on validity of C-reactive protein in deciding the duration of antibiotic therapy in suspected neonatal bacterial infection

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20173796 ◽

2017 ◽

Vol 4 (5) ◽

pp. 1838 ◽

Cited By ~ 1

Author(s):

Prashanth Siddaiah ◽

Pradeep Nanjappa Shetty ◽

Krishna N. W. ◽

Sowmya Jagadeeshwara

Keyword(s):

Antibiotic Therapy ◽

Bacterial Infection ◽

Negative Predictive Value ◽

Antibiotic Treatment ◽

Predictive Value ◽

Decision Criterion ◽

C Reactive Protein ◽

Neonatal Septicemia ◽

Reactive Protein ◽

Serum Crp

Background: Neonatal septicemia is defined as generalized bacterial infection of newborns documented by positive blood culture in first four weeks of life. Objective of present study was to determine whether C-Reactive protein can be used as a parameter to identify the time point when antibiotic treatment can safely be discontinued in a defined major subgroup of neonates treated for suspected bacterial infection.Methods: A total of 50 neonates with birth weight more than 1500gms with suspected septicemia were enrolled in the prospective study. Serum CRP were determined 24-48 hours after the first dose of antibiotics. If CRP was less than 6mg/l, infants were considered unlikely to be infected and the antibiotic treatment was stopped. If CRP was more than 6mg/l, antibiotics were continued and CRP measured on alternative days in one subgroup (2a) and on seventh day in another subgroup (2b). CRP was the single decision criterion to stop the antibiotic therapy. Negative predictive value with respect to further treatment was determined.Results: Duration of antibiotic therapy could be reduced to less than seven days in 54% cases and < 72 hours in 48% cases.Conclusions: Negative predictive value of serial CRP is 100% in deciding the duration of antibiotic therapy in suspected neonatal septicemia.

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Diagnostic Value of Urine sTREM-1 and Urine C-reactive Protein for Infants with Late Onset Neonatal Sepsis

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0039-3400468 ◽

2019 ◽

Vol 15 (02) ◽

pp. 072-078

Author(s):

Senem Alkan Ozdemir ◽

Ruya Colak ◽

Ezgi Yangin Ergon ◽

Sebnem Calkavur

Keyword(s):

Neonatal Sepsis ◽

Predictive Value ◽

Late Onset ◽

Diagnostic Value ◽

C Reactive Protein ◽

Reactive Protein ◽

Late Onset Sepsis ◽

Noninvasive Markers ◽

Serum Crp ◽

Sepsis Detection

Abstract Objective Noninvasive markers have been increasingly used as a diagnostic marker for sepsis detection and monitoring of the disease. The aim of this observational, prospective pilot study was to investigate the diagnostic performance of urinary soluble triggering receptor expressed on myeloid cells (sTREM-1) and urine C-reactive protein (CRP) levels in the late onset neonatal sepsis and to compare them with serum CRP levels. Materials and Methods Sixty-six infants with clinical sepsis were included. Urine sTREM-1 and urine CRP were collected at the diagnosis of late-onset sepsis. All laboratory investigations were also noted from the infants. Results There were no significant differences between characteristics of the infants. Culture-positive neonates had significantly higher urine sTREM-1 than culture-negative neonates (p < 0.001). Using a cut-off point for urine sTREM-1 of 129 pg/mL, the sensitivity was 0.63, the specificity was 0.84, positive predictive value was 0.80, negative predictive value was 0.70. Urine sTREM-1 and urine CRP were recollected on the seventh day of sepsis treatment and it was found that the levels of sTREM-1 and CRP decreased. Conclusion This is the first study in the literature which evaluates the place of urine sTREM-1 and urine CRP in the diagnosis of neonatal sepsis. Urine sTREM-1 and urine CRP may be useful in the diagnosis of sepsis and in evaluating the effect of antibiotic treatment.

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Predictive value of C-reactive protein with Alvarado score in acute appendicitis

ANZ Journal of Surgery ◽

10.1111/ans.12408 ◽

2013 ◽

Vol 84 (5) ◽

pp. 335-336 ◽

Cited By ~ 5

Author(s):

Siva Thirumallai ◽

Suraj Ruwan Wijesuriya ◽

Andrew Mitchell ◽

Luc Delriviere

Keyword(s):

Acute Appendicitis ◽

Predictive Value ◽

C Reactive Protein ◽

Alvarado Score ◽

Reactive Protein

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C-reactive protein, as a marker for predicting acute appendicitis and its severity in KVG medical college and hospital, Sullia

International Surgery Journal ◽

10.18203/2349-2902.isj20213984 ◽

2021 ◽

Vol 8 (10) ◽

pp. 3002

Author(s):

Abhirup H. Ramu ◽

Priyanka Kenchetty ◽

Aishwarya K. Chidananda

Keyword(s):

Acute Appendicitis ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

False Negative ◽

Clinical Suspicion ◽

C Reactive Protein ◽

Common Procedure ◽

Medical College ◽

Reactive Protein

Background: Appendicectomy for suspected acute appendicitis is a common procedure. The rate of normal appendices unnecessarily removed remains high despite several techniques and investigations used to improve the diagnostic accuracy. This study emphasizes the value of C reactive protein (CRP) in three groups of patients operated for clinical suspicion of acute appendicitis with different finding at appendicectomy namely an un-inflamed appendix, uncomplicated acute appendicitis or complicated acute appendicitis.Methods: This prospective study was performed on 100 consecutive patients who were operated on for treatment of acute appendicitis in KVG medical college and hospital between 01 August 2019 to 01 February 2021. Clinically proven by a surgeon, patients underwent appendicectomy. Serum CRP results of all patients were determined. Sensitivity, specificity, positive predictive value and negative predictive value were calculated. Statistical analysis will be made using descriptive statistic and SPSS version 21 was used for analysis.Results: The percentage of negative laparotomies was 13% and surgeon ‘s clinical suspicion was true in 87%. Preoperative CRP values were false negative in 21 patients with appendicitis and false positive in 2 patients with normal appendix. The difference of true and false results between CRP tests and surgeon’s diagnosis was statistically significant (p=0.001). Present study revealed, sensitivity=76%, specificity=87.5%, positive predictive value=96% and negative predictive value=41%.Conclusions: Serum C reactive protein when elevated supports the surgeon’s clinical diagnosis of acute appendicitis. It can be used frequently to diagnosis the acute appendicitis, so that the complication rate and negative laparotomies can be avoided.

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The value of serum C reactive protein in the assessment of severity of HIV infection among children in a resource limited setting

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20203455 ◽

2020 ◽

Vol 8 (8) ◽

pp. 3007

Author(s):

Otobong C. Udoh ◽

Ofonime T. Dixon umo ◽

Enobong U. Bassey

Keyword(s):

Hiv Infection ◽

Cost Effective ◽

Well Being ◽

Clinical Feature ◽

Enzyme Linked Immunosorbent Assay ◽

C Reactive Protein ◽

Female Ratio ◽

Reactive Protein ◽

Resource Limited ◽

Serum Crp

Background: Human immuno-deficiency virus (HIV) infection has devastating impact especially on well-being of children. Management of HIV infected children in resource-limited countries poses significant difficulties. The role of C-reactive protein as a potentially useful/cost-effective tool for assessing severity of HIV infection is yet to be established. The relationship between serum C-reactive protein and severity of HIV infection among children aged 6 months to 12 years was evaluated.Methods: Authors recruited 85 children each on combined antiretrovirals for ≥3 months, and apparently healthy HIV-negative controls. Severity of HIV infection was assessed by classification into immunologic categories 1, 2, 3 and clinical categories N, A, B, C according to the Centre for Disease Control revised classification system. Enzyme linked immunosorbent assay (ELISA) was used for serum CRP estimation. CD4 count was estimated by flow cytometry. Data analysis was with Statistical Package for Social Sciences version 20.Results: Response rate was 160 (94.1%) with mean age of participants being 8.50±3.36 years. Male to female ratio was 1.35:1. Lymphadenopathy was the commonest clinical feature in 26 (32.50%) participants, 59 (73.75%) participants were asymptomatic, and 52 (65.00%) were immunologic stage 1. Median serum CRP of HIV infected group and controls were 4.2 (1-13.9) mg/l and 0.5 (0.2-1.9) mg/l respectively. There was an association between Clinical and immunolological stages of infection and levels of serum CRP, p values = 0.001 and 0.002 respectively.Conclusions: The serum level of CRP may predict the severity of HIV infection among children.

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Diagnostic Value of Interleukin-6 and C-Reactive Protein in Acute Appendicitis

Swiss Surgery ◽

10.1024/1023-9332.6.4.169 ◽

2000 ◽

Vol 6 (4) ◽

pp. 169-172 ◽

Cited By ~ 26

Author(s):

Erkasap ◽

Ates ◽

Ustuner ◽

Sahin ◽

Yilmaz ◽

...

Keyword(s):

Acute Appendicitis ◽

Interleukin 6 ◽

Iliac Fossa ◽

Diagnostic Value ◽

C Reactive Protein ◽

Reactive Protein ◽

Perforated Appendix ◽

Right Iliac Fossa Pain ◽

The Mean ◽

Serum Crp

The aim of this study is prospectively to evaluate the serum C-reactive protein (CRP) and interleukin-6 (IL-6) levels in detection of acute appendicitis in patients with right iliac fossa pain. Data were collected in prospective manner on 102 consecutive patients with right iliac fossa pain. Laparotomy was performed for suspected acute appendicitis for 55 of the 102 patients, of whom 49 patients had appendicitis, 6 patients non-appendicitis (NA), and the other 47 patients had nonspecific abdominal pain (NSAP) and they did not undergo operation. Among those with appendicitis 31 had acute appendix (AA), 8 had gangrenous appendix (GA), and 10 had perforated appendix (PA). The WBC and CRP the mean (SEM) values were significantly different in AA, GA, and PA groups compared with NSAP and NA groups (P < 0.05). Although the mean IL-6 levels were significantly different only in PA group than the others groups (P < 0.05). The sensitivity and specificity of serum CRP measurements were calculated as 96% and 87%, respectively whereas these were 33% and 83% for IL-6 levels for the diagnosis of the acute appendicitis. As a result, measurement of the CRP levels and WBC have an additional diagnostic value on the diagnosis of the acute appendicitis but determination of IL-6 levels which added to the test combination of WBC and CRP, the sensitivity for the diagnosis of the acute appendicitis was not changed whereas the specificity was decreased to 66%.

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