Diagnostic Value of C-Reactive Protein/Albumin Ratio to Differentiate Simple Versus Complicated Appendicitis

Abstract Background: No reliably specific marker for complicated appendicitis has been identified. Serum C-reactive protein (CRP) increases and albumin (ALB) decreases in patients with inflammation and infection. C-reactive protein and albumin ratio (CRP/ALB ratio) has been found associated with neonatal septicemia, inflammatory bowel disease and pancreatitis. However, its value in the diagnosis of complicated appendicitis has not been studied. The aim of this study was to evaluate the value of CRP/ALB ratio for predicting complicated appendicitis in children.Methods: A retrospective study of 232 children with acute appendicitis was conducted with assessment of age, gender, weight, symptom duration, albumin and blood routine indexes. According to intraoperative findings and postoperative pathological results, patients were divided into the simple appendicitis group (127 cases) and complicated appendicitis group (105 cases). SPSS version 17 was used to analyse the data.Results: Of the 232 patients, 118 (50.9%) were male and 114 (49.1%) were female. The age range was 1 to 15 years, the mean age of the patients was 8.30 ± 3.25 years. The CRP/ALB ratio was higher in complicated appendicitis compared with simple appendicitis(p<0.05). Logistic regression analysis showed that mononuclear cell (MC), CRP, procalcitonin (PCT) and CRP/ALB ratio were independent risk factors for complicated appendicitis in children. Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of CRP/ALB ratio was higher than MC, PCT and CRP (0.946 vs 0.619 vs 0.843 vs 0.906). CRP/ALB ratio >1.43 was found to be a significant marker in predicting complicated appendicitis with 91.4 % sensitivity and 90.6 % specificity. Compared with CRP/ALB ratio=<1.43, patients with CRP/ALB ratio >1.43 had a 102.22 times higher chance of complicated appendicitis (95% CI:41.322 - 252.874).Conclusion: The CRP/ALB ratio is a novel and promising indicator to predict complicated appendicitis in children before operation，which is easy-to-measure and repeatable. Therefore, CRP/ALB ratio can provide a reference for the choice of surgical treatment for acute appendicitis in children.

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Comparing the Diagnostic Value of the C-Reactive Protein to Albumin Ratio With Other Inflammatory Markers in Patients With Stable Angina Pectoris

Angiology ◽

10.1177/0003319719897490 ◽

2019 ◽

Vol 71 (4) ◽

pp. 360-365 ◽

Cited By ~ 4

Author(s):

Zulkif Tanriverdi ◽

Fatih Gungoren ◽

Mustafa Begenc Tascanov ◽

Feyzullah Besli ◽

Ibrahim Halil Altiparmak

Keyword(s):

Uric Acid ◽

Angina Pectoris ◽

Stable Angina ◽

Diagnostic Value ◽

C Reactive Protein ◽

Stable Angina Pectoris ◽

Albumin Ratio ◽

Lymphocyte Ratio ◽

Reactive Protein ◽

Inflammatory Parameters

Several laboratory parameters have been used to assess inflammatory process and determine cardiovascular risk. The C-reactive protein to albumin ratio (CAR) is a novel marker of inflammation and its clinical importance has not been clearly elucidated in coronary artery disease (CAD). We compared the diagnostic value of CAR with other inflammatory parameters in detecting significant CAD. Patients (n = 421) with stable angina pectoris who underwent coronary angiography for the suspected CAD were included. Neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), platelet to lymphocyte ratio, uric acid, monocyte to high-density cholesterol (HDL-C) ratio, mean platelet volume to lymphocyte ratio (MPVLR), and platelet to mean corpuscular volume (MCV) ratio were measured. Patients with significant CAD had a significantly higher NLR ( P = .043), MLR ( P = .004), uric acid ( P < .001), monocyte to HDL-C ratio ( P = .004), and CAR ( P < .001) compared to patients without significant CAD. However, MPVLR and platelet to MCV ratio weren’t different between 2 groups. The area under the curve (AUC) of CAR was the highest AUC among all inflammatory parameters for predicting significant CAD. Multivariate analysis showed that age (odds ratio [OR]: 1.046, 95% confidence interval [CI], 1.020-1.072, P < .001) and CAR (OR: 1.175, 95% CI, 1.126-1.226, P < .001) were the only independent predictors of significant CAD. In conclusion, CAR had the strongest diagnostic value in detecting significant CAD among the inflammatory parameters evaluated in this study.

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Mean Platelet Volume/Platelet Count Ratio as a Diagnostic Marker in Children with Acute Appendicitis

Journal of Dr Behcet Uz Children s Hospital ◽

10.5222/buchd.2021.72335 ◽

2021 ◽

Author(s):

İnanç Karakoyun ◽

Mustafa Onur Öztan

Keyword(s):

Platelet Count ◽

Acute Appendicitis ◽

Mean Platelet Volume ◽

Diagnostic Value ◽

Complicated Appendicitis ◽

C Reactive Protein ◽

Platelet Volume ◽

Reactive Protein ◽

Uncomplicated Appendicitis ◽

Wbc Count

Objective: The objective of this research was to evaluate the diagnostic value of mean platelet volume/platelet count (MPV/PC) ratio in pediatric acute appendicitis. Methods: This retrospective study included a total of 310 patients, 176 in the uncomplicated appendicitis group, 80 in the complicated appendicitis group, and 54 in the nonspecific abdominal pain (NSAP) group. C-reactive protein (CRP) level, white blood cell (WBC) count, absolute neutrophil count (ANC), MPV, PC, and MPV/PC ratio were compared between the groups. Results: WBC and ANC levels differed significantly between the groups (P<0.001 in all pairwise comparisons). CRP levels in the complicated appendicitis group were higher than in the NSAP and uncomplicated appendicitis groups (P<0.001 for both comparisons). There was a negative correlation between MPV and PC (r= -0.434, P<0.001). Both PC and MPV/PC ratio were able to distinguish cases of complicated appendicitis from NSAP (P=0.047 and P=0.045, respectively) and from cases of uncomplicated appendicitis (P=0.010 and P=0.045, respectively). Areas under the ROC curve for CRP, WBC, ANC, MPV, PC, and MPV/PC ratio were 0.640, 0.690, 0.727, 0.553, 0.541, and 0.546, respectively. Conclusion: According to the results of our study, MPV/PC ratio can be used in addition to the conventional markers to discriminate cases of complicated appendicitis.

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C -reactive protein and albumin ratio for the diagnosis of complicated appendicitis in children

10.21203/rs.2.18030/v2 ◽

2020 ◽

Author(s):

Wei Feng ◽

Qian-Yu Yang ◽

Xu-Feng Zhao ◽

Miao-Miao Li ◽

Hua-Lei Cui

Keyword(s):

Characteristic Curve ◽

Prognostic Score ◽

Area Under The Curve ◽

Complicated Appendicitis ◽

Symptom Duration ◽

Specific Marker ◽

C Reactive Protein ◽

Albumin Ratio ◽

Reactive Protein ◽

Independent Risk Factors

Abstract Background: No reliably specific marker for complicated appendicitis has been identified. Serum C-reactive protein (CRP) and albumin (ALB) ratio (CRP/ALB ratio) has been a new inflammation-based prognostic score which is associated with the severity of inflammation. However, its value in the diagnosis of complicated appendicitis has not been studied. The aim of this study was to evaluate the predictive value of CRP/ALB ratio for complicated appendicitis in children. Methods: A retrospective study of 232 children with acute appendicitis was conducted with assessment of age, gender, symptom duration, albumin and blood routine indexes on admission. According to intraoperative findings and postoperative pathological results, patients were divided into the simple appendicitis group (127 cases) and complicated appendicitis group (105 cases). SPSS version 17 was used to analyse the data. Results: Of the 232 patients, 118 (50.9%) were male and 114 (49.1%) were female. The CRP/ALB ratio was higher in complicated appendicitis compared with simple appendicitis (p<0.05). Logistic regression analysis showed that the higher levels of mononuclear cell count (MC), CRP, procalcitonin (PCT) and CRP/ALB ratio were independent risk factors for complicated appendicitis in children. Receiver operating characteristic curve analysis showed that the area under the curve of CRP/ALB ratio (0.946) was was bigger than MC (0.619), CRP (0.906) and PCT (0.843). CRP/ALB ratio >1.43 was found to be a significant marker in predicting complicatedappendicitis with 91.4% sensitivity and 90.6% specificity. Compared with CRP/ALB ratio =<1.43, patients with CRP/ALB ratio >1.43 had a 102.22 times higher chance of complicated appendicitis (95% CI: 41.322 - 252.874). Conclusion: Admission CRP/ALB ratio was significantly higher in children with acute complicated appendicitis. It is a novel but promising hematological marker that aids the differentiation of acute complicated and simple appendicitis.

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Diagnostic Value of C-reactive Protein in Complicated Appendicitis

Journal of the Korean Society of Coloproctology ◽

10.3393/jksc.2011.27.3.122 ◽

2011 ◽

Vol 27 (3) ◽

pp. 122 ◽

Cited By ~ 10

Author(s):

Hyoung-Min Moon ◽

Beom-Seok Park ◽

Duk-Jin Moon

Keyword(s):

Diagnostic Value ◽

Complicated Appendicitis ◽

C Reactive Protein ◽

Reactive Protein

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Predictive Significance of C-reactive Protein-to-albumin Ratio for Postoperative Pancreatic Fistula After Pancreaticoduodenectomy

Anticancer Research ◽

10.21873/anticanres.13838 ◽

2019 ◽

Vol 39 (11) ◽

pp. 6283-6290 ◽

Cited By ~ 2

Author(s):

TERUHISA SAKAMOTO ◽

YAKUKI YAGYU ◽

EI UCHINAKA ◽

MASAKI MORIMOTO ◽

TAKEHIKO HANAKI ◽

...

Keyword(s):

Pancreatic Fistula ◽

Postoperative Pancreatic Fistula ◽

C Reactive Protein ◽

Albumin Ratio ◽

Reactive Protein

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Dynamic prediction for clinically relevant pancreatic fistula: a novel prediction model for laparoscopic pancreaticoduodenectomy

BMC Surgery ◽

10.1186/s12893-020-00968-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Runwen Liu ◽

Yunqiang Cai ◽

He Cai ◽

Yajia Lan ◽

Lingwei Meng ◽

...

Keyword(s):

Prediction Model ◽

Pancreatic Fistula ◽

Postoperative Pancreatic Fistula ◽

Laparoscopic Pancreaticoduodenectomy ◽

C Reactive Protein ◽

Dynamic Prediction ◽

Albumin Ratio ◽

Drainage Fluid ◽

Reactive Protein ◽

Baseline Factors

Abstract Background With the recent emerge of dynamic prediction model on the use of diabetes, cardiovascular diseases and renal failure, and its advantage of providing timely predicted results according to the fluctuation of the condition of the patients, we aim to develop a dynamic prediction model with its corresponding risk assessment chart for clinically relevant postoperative pancreatic fistula after laparoscopic pancreaticoduodenectomy by combining baseline factors and postoperative time-relevant drainage fluid amylase level and C-reactive protein-to-albumin ratio. Methods We collected data of 251 patients undergoing LPD at West China Hospital of Sichuan University from January 2016 to April 2019. We extracted preoperative and intraoperative baseline factors and time-window of postoperative drainage fluid amylase and C-reactive protein-to-albumin ratio relevant to clinically relevant pancreatic fistula by performing univariate and multivariate analyses, developing a time-relevant logistic model with the evaluation of its discrimination ability. We also established a risk assessment chart in each time-point. Results The proportion of the patients who developed clinically relevant postoperative pancreatic fistula after laparoscopic pancreaticoduodenectomy was 7.6% (19/251); preoperative albumin and creatine levels, as well as drainage fluid amylase and C-reactive protein-to-albumin ratio on postoperative days 2, 3, and 5, were the independent risk factors for clinically relevant postoperative pancreatic fistula. The cut-off points of the prediction value of each time-relevant logistic model were 14.0% (sensitivity: 81.9%, specificity: 86.5%), 8.3% (sensitivity: 85.7%, specificity: 79.1%), and 7.4% (sensitivity: 76.9%, specificity: 85.9%) on postoperative days 2, 3, and 5, respectively, the area under the receiver operating characteristic curve was 0.866 (95% CI 0.737–0.996), 0.896 (95% CI 0.814–0.978), and 0.888 (95% CI 0.806–0.971), respectively. Conclusions The dynamic prediction model for clinically relevant postoperative pancreatic fistula has a good to very good discriminative ability and predictive accuracy. Patients whose predictive values were above 14.0%, 8.3%, and 7.5% on postoperative days 2, 3, and 5 would be very likely to develop clinically relevant postoperative pancreatic fistula after laparoscopic pancreaticoduodenectomy.

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Diagnostic value of procalcitonin, erythrocyte sedimentation rate (ESR), quantitative C-reactive protein (CRP) and clinical findings associated with osteomyelitis in patients with diabetic foot

Human Antibodies ◽

10.3233/hab-210439 ◽

2021 ◽

pp. 1-7

Author(s):

Zahra Soleimani ◽

Fatemeh Amighi ◽

Zarichehr Vakili ◽

Mansooreh Momen-Heravi ◽

Seyyed Alireza Moravveji

Keyword(s):

Erythrocyte Sedimentation Rate ◽

Sedimentation Rate ◽

Roc Curve ◽

Diabetic Foot ◽

Diagnostic Value ◽

Clinical Findings ◽

Diabetic Patients ◽

C Reactive Protein ◽

Reactive Protein ◽

Erythrocyte Sedimentation

BACKGROUND: The diagnosis of osteomyelitis is a key step of diabetic foot management. Procalcitonin (PCT) is a novel infection marker. This study aimed to investigate the diagnostic value of procalcitonin and other conventional infection markers and clinical findings in diagnosis of osteomyelitis in diabetic foot patients. METHODS AND MATERIALS: This diagnostic value study was carried out on ninety patients with diabetic infected foot ulcers admitted in Kashan Beheshti Hospital, 2016. After obtaining consent, 10 cc blood sample was taken for measuring serum PCT, CBC, ESR, CRP and FBS. Clinical characteristics of the wounds were noted. Magnetic resonance imaging of the foot was performed in all patients to diagnose osteomyelitis. All statistical analyses were done with the use of SPSS-16. RESULTS: PCT levels were 0.13 ± 0.02 ng/mili patients with osteomyelitis (n= 45) and 0.04 ± 0.02 ng/ml in patients without osteomyelitis (n= 45). PCT, Erythrocyte sedimentation rate and C-reactive protein was found significantly higher in patients with osteomyelitis (p< 0.001). The ROC curve was calculated for PCT. The area under the ROC curve for infection identification was 1 (p< 0.001). The best cut-off value for PCT was 0.085 ng/ml. Sensitivity, specificity, and positive and negative predictive values were 100%, 97.8%,97.8% and 100%, respectively. CONCLUSION: In this group of patients, PCT was useful to discriminate patients with bone infection. Also, Erythrocyte sedimentation rate and C-reactive protein can be used as a marker of osteomyelitis in diabetic patients.

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