Comparison of Diagnostic Value of ESR, CRP and Leukocytosis with Pathologic Findings among Patients with Acute Appendicitis

Abstract

Background: Acute appendicitis is a serious condition that is occasionally falsely diagnosed. The correct diagnosis of this condition helps reduce unnecessary surgeries or complications due to the lack of diagnosis. Laboratory tests are used to diagnose this condition. The present study was conducted to compare the diagnostic value of the ESR, the CRP level and leukocytosis with pathological findings in patients with acute appendicitis.

Methods: This descriptive study examined 125 cases with a primary diagnosis of appendicitis from August 2015 to October 2016 at Imam Hossein Hospital in Shahroud, Iran. The patients’ blood samples were collected for ESR, CRP and leukocyte testing and were then sent to the laboratory. After the appendectomies, samples of their appendices were sent to the pathology laboratory for further examination. The blood test results were compared with the pathological findings and analyzed in terms of sensitivity, specificity and positive and negative predictive values.

Results: In this study, 59.2% of the cases were male and the rest were female. Acute appendicitis and other pathological appendices were confirmed in 91 patients (72.8%) based on their pathological evaluation and 34 cases (27.2%) were reported as normal. The sensitivity and specificity were obtained as 57.1% and 79.4% for ESR. These indices were 78.0% and 83.5% for CRP and 74.4% and 50% for leukocytosis.

Conclusions: The results of this study showed that, in addition to basic laboratory findings, ESR, CRP and leukocytosis testing can also be helpful in the correct diagnosis of acute appendicitis; however, the predictive value of CRP was the highest.