Haider Kazmi Syed Jawad, Tabassum Shaesta, Asghar Muhammad Sohaib, Siddiqui Muhammad Ali, Yasmin Farah, Tahir Muhammad Junaid, Aziz Yumnah, Kirmani Tooba Ahmed, Ahmed Mansoor
Department of Emergency Medicine, Liaquat National Hospital and Medical College, Karachi, Pakistan.
Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Ann Med Surg (Lond). 2022 Apr 1;76:103524. doi: 10.1016/j.amsu.2022.103524. eCollection 2022 Apr.
It is important to promptly assess the severity of appendicitis since late diagnosis can proceed towards perforation, peritonitis and sepsis. The main objective of this study is to decipher the ability of CRP, TLC and neutrophils in acute appendicitis to predict complications and perforation in pediatric age group.
This cohort study was conducted in the Pediatric Surgery Department of Liaquat National Hospital, Karachi. It included all the patients diagnosed and operated on for acute appendicitis within the pediatric age group.
The median (IQR) age of study population was 9 (7-11) years, the majority of which fell into 6-12 years of age group with 70% males. Histopathology came out positive in 127 individuals. Out of those 127 patients, 45.9% (n = 62) had simple appendicitis and 48.1% (n = 65) had complicated appendicitis (n = 65), while 37 (27.4%) had shown perforation. The majority of individuals had suppurative appendicitis on histopathology (35.6%). On receiver operating characteristic (ROC) analysis, CRP has the highest specificity for complicated appendicitis and the highest positive likelihood ratio for both complicated and perforated appendicitis.
CRP was observed in our study to be an independent marker of severity in acute appendicitis.
及时评估阑尾炎的严重程度很重要，因为诊断延迟可能会发展为穿孔、腹膜炎和败血症。本研究的主要目的是解读急性阑尾炎中C反应蛋白（CRP）、白细胞总数（TLC）和中性粒细胞预测小儿年龄组并发症和穿孔的能力。
本队列研究在卡拉奇利亚卡特国家医院小儿外科进行。研究对象包括小儿年龄组内所有诊断为急性阑尾炎并接受手术的患者。
研究人群的中位（四分位间距）年龄为9（7 - 11）岁，其中大多数为6 - 12岁年龄组，男性占70%。组织病理学检查127例呈阳性。在这127例患者中，45.9%（n = 62）为单纯性阑尾炎，48.1%（n = 65）为复杂性阑尾炎，37例（27.4%）出现穿孔。组织病理学检查大多数患者为化脓性阑尾炎（35.6%）。在受试者工作特征（ROC）分析中，CRP对复杂性阑尾炎具有最高特异性，对复杂性阑尾炎和穿孔性阑尾炎均具有最高阳性似然比。
在我们的研究中观察到CRP是急性阑尾炎严重程度的独立标志物。
