Accuracy of C-Reactive Protein and Procalcitonin in Differentiating between Complicated and Non-complicated Acute Appendicitis Patients in Babylon Province


Background: Clinical care may be influenced by the ability to predict whether a patient has complicated appendicitis at the timeof presentation. However, it is unclear whether prehospital or in-hospital factors are associated with complicated appendicitis.We also want to know if C-reactive protein (CRP) and procalcitonin (PCT) can be used as supporting factors for AlvaradoScore associated with complex appendicitis. Objectives: The aim of this study is to know the possibility of adding CRP andPCT to support the diagnostic protocol for differentiating between complicated acute appendicitis and noncomplicated acuteappendicitis by knowing the sensitivity and specificity of each of them, as well as knowing which is more acceptable to add to thediagnostic protocol. Materials and Methods: A cross-sectional study was carried out in the Emergency Unit at AL-Hilla TeachingHospital in Babylon province, Hilla city, between October 2021 and January 2022. There were a total of 90 patients; CRP andPCT were measured for patients by enzyme-linked immunosorbent assay method, in addition to knowing their Alvarado score.SPSS software was used to conduct the statistical analysis. Results: At the time of surgery, 34 (40%) of the 90 patients hadcomplicated appendicitis, whereas 54 (60%) without complication. The age and gender of the groups did not show any significantdifference. The Alvarado score, CRP, and PCT levels all showed a significant difference (P < 0.05). The correlation betweenAlvarado score and biochemical parameters (CRP and PCT) show a significant positive correlation. Conclusions: CRP and PCTsupport Alvarado score to differentiate between complicated acute appendicitis and noncomplicated acute appendicitis, and thisis evident from the significantly higher concentrations of both in patients with complicated acute appendicitis than in patientswith noncomplicated acute appendicitis.


Appendicitis, CRP, Iraq, PCT