Biomarkers of Acute Appendicitis Severity: Diagnostic Test Study

Abstract

Appendicitis (AA) is one of the most frequent abdominal surgical pathologies in the world, with appendectomy being the most frequently performed emergency surgery worldwide. This study was conducted to determine the possible biomarkers to detect the severity in AA for diagnostic purposes, and for the timely management of appendicitis and, thereby avoiding possible complications. This research was conducted based on a randomized sampling, where a total of 239 patients diagnosed with AA at the Hospital Regional de Orinoquia, Colombia was recruited for this study. Blood count, C–reactive protein (CRP), and neutrophil/lymphocyte ratio (NLR) records were analyzed, further their relationship with the surgical findings of AA described by Guzman–Valdivia was established. The study showed that, in the emergency department, these reactants are capable of making an approximate diagnosis and as biomarkers of the severity of AA, with CRP>15mg/dL (diagnostic accuracy 76.15%), and the percentage of neutrophils>85% (diagnostic accuracy 61.09%) being the best initial operative performance. For complications, such as intestinal perforation, CRP>15mg/dL and neutrophil percentage>85% were found statistically to be the biomarkers with the highest predictive performance, with OR 14.46, and OR 2.17, respectively, which is consistent with the findings described by Guzman–Valdivia. In conclusion, elevated level of CRP and neutrophil percentage>85 is the acute phase reactants with the best diagnostic characteristics and predictors of possible complications of AA.