CRP versus Alvarado Score in Appendicitis Diagnosis

Abstract

Objective:To evaluate whether C-reactive protein (CRP) level results on admission could aid the diagnostic accuracy of Alvarado score in patients with suspected appendicitis. Study Type: cross sectional study. Study Place and Duration: January to December 2019 in the Surgical Unit, Nishtar Hospital, Multan.

Material and methods: Total 230 patients participated in the study with suspected acute appendicitis. Patient’s Alvarado score, age of the patients, sex, length of period of complaint for abdominal pain and level of CPR were recorded on the time of admission. Descriptive statistics for study data included mean, median, standard deviation, minimum and maximum frequency and ratio values. Quantitative data was examined using Mann-Whitney U test. On the other hand a receiver operating characteristic curve was used for effects and cut-off values.

Results: The mean C-reactive protein of AA complicated and AA uncomplicated patients was 40.61±9.59 mg/L and 38.25±9.08 mg/L, respectively. The difference was statistically insignificant, (p=0.905). The mean Alvarado score of AA complicated and AA uncomplicated patients was 7.51±1.72 and 7.75±2.08, respectively. The difference was statistically insignificant, (p=0.248).

Conclusion: Serum levels of C-reactive protein when assessed alone are not adequate enough in making a diagnosis of acute appendicitis. When combined with Alvarado score, they increase the overall diagnostic value. Moreover these levels in serum also help in differentiation of uncomplicated and complicated acute appendicitis.