The potential of acute-phase reactants as severity predictors in acute appendicitis. A prospective study

Abstract

The search for highly specific, sensitive, and highly predictive paraclinical indicators, such as CRP and ESR, is still ongoing. These indicators may favor a more accurate diagnosis, decreasing the complication rate in patients with acute appendicitis, and reducing diagnostic errors and prolonged stays. OBJECTIVE: To evaluate the potential of acute phase reactants as predictors of severity in patients diagnosed with acute appendicitis treated in the Surgery Department of the “Dr. Enrique Tejera” Hospital City. MATERIALS: Observational - descriptive study, field design, non-experimental, prospective, and cross-sectional. Deliberate, non-probabilistic volunteer sample comprised of 77 patients who met the inclusion criteria. Data collection was through direct, participatory, and structured observation techniques. Results were presented in frequency distributions and contingency tables. RESULTS: The predominant clinical manifestation was pain in the right iliac fossa in all patients (77 cases), followed by nausea (75.32%). Surgical resolution took between 1 and 2 days (51.95%). Positive PCR results (n=71) and positive ESR (n=22) were proportionally more frequent in all types of appendicitis; however, no statistically significant association (P?0.05) was demonstrated between the type of appendicitis and the PCR and ESR results, respectively. CONCLUSIONS: Positive PCR results were proportionally more frequent in all types of appendicitis, particularly in gangrenous appendicitis, with no statistically significant association between the type of appendicitis and the PCR results (P>0.05). Positive ESR was proportionally more frequently present in the perforated and gangrenous types, with no statistically significant association between the type of appendicitis and the ESR result (P>0.05).