alexa Inclusion of C-Reactive Protein and White Blood Cell Count in Diagnostic Workup of Patients with Clinically Suspected Appendicitis Stratifies for Imaging
ISSN: 2168-9784

Journal of Medical Diagnostic Methods
Open Access

OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations

700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

Research Article

Inclusion of C-Reactive Protein and White Blood Cell Count in Diagnostic Workup of Patients with Clinically Suspected Appendicitis Stratifies for Imaging

R.R van Tol1, S.O. Breukink1, M.J. Lahaye2 and JPM. Derikx1,3*

1Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands

2Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands

3Pediatric surgical center of Amsterdam (Emma children hospital AMC/VUMC), Amsterdam, The Netherlands

*Corresponding Author:
J.P.M. Derikx
Department of Surgery
Maastricht University Medical center
P. Debeyelaan 25, PO Box 5800
6229 HX Maastricht,The Netherlands
Tel: +31433881494
E-mail: [email protected]

Received date: Mar 29, 2016; Accepted date: May 18, 2016; Published date: May 25, 2016

Citation: van Tol RR, Breukink SO, Lahaye MJ, Derikx JPM (2016) Inclusion of C-Reactive Protein and White Blood Cell Count in Diagnostic Workup of Patients with Clinically Suspected Appendicitis Stratifies for Imaging. J Med Diagn Meth 5:212. doi:10.4172/2168-9784.1000212

Copyright: © 2016 van Tol RR, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited



Objectives: The aim of this retrospective study was to clarify whether plasma markers that are routinely used in the workup of patients suspected for acute appendicitis (AA) can stratify for imaging in both adults and children.

Methods: A total of 1388 patients suspected of AA between January 2008 and till 2012 were included. CRP and WBC concentrations were retrospectively abstracted from the electronic health record. Receiver operating characteristic (ROC) curves were used to assess the diagnostic accuracy for the tests and to determine the best cutoff points.

Results: In total 432 (22.4%) patients had histopathologically proven AA of whom 45 patients (10.4%) had perforated appendictis. The area under the curve (AUC 95% confidence interval [CI]) was 0.74 (95% CI = 0.70 to 0.77) for CRP and 0.74 (95% Cl = 0.71 to 0.78) for WBC both in adults and children. No cut off points had high enough sensitivity and specificity to accurately diagnose (perforated) AA. However, a high sensitivity of 91% was shown at cut-off 7.5x109/L WBC for AA (both in adults and children). In total 244 (18%) had a cut-off < 7.5×109/L. Those patients could have been sent home. Only 21 (5%) patients would have been missed in the AA group and 1(0.5%) patient in the perforated appendicitis group.

Conclusions: None had clinical relevant cutoff points that could accurately discriminate between AA and other pathology, neither perforated appendicitis. However, WBC < 7.5×109/L for AA can identify a subgroup of 245 out of 1388 (18%) patients that could have been sent home without further imaging.


Share This Page

Additional Info

Loading Please wait..
Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals


[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version