C reactive protein in the diagnosis of acute appendicitis.

OBJECTIVE

To find out if the C reactive protein concentration is of any value in the diagnosis of acute appendicitis, either alone or in combination with other laboratory tests.

DESIGN

Open study.

SETTING

Drechtsteden Hospital, Dordrecht, and Spaarne Hospital, Heemstede, The Netherlands.

SUBJECTS

209 consecutive patients admitted with suspected appendicitis.

MAIN OUTCOME MEASURES

Correlation of C reactive protein concentration with age, sex, body temperature, duration of abdominal pain, anorexia, nausea, vomiting, white cell count, neutrophil count, erythrocyte sedimentation rate, and histological appearance of the appendix.

RESULTS

125 patients of the 209 patients had their appendixes removed, and of these 101 had histologically confirmed appendicitis: A C reactive protein concentration of > or = 6 mg/1 alone had a sensitivity of 87% and a specificity of 50%. When the selected variables were subjected to multivariate analysis the most important, in decreasing order, were white blood cell count, female sex, and C reactive protein concentration. Combining the variables was of no additional value.

CONCLUSION

measurement of the C reactive protein concentration can increase the accuracy in the diagnosis of acute appendicitis.