Study of the association of serum procalcitonin with leukocytosis in predicting complicated acute appendicitis

Authors

  • Thana Ram Patel Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India
  • Amit Jain Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India
  • Lakshman Agarwal Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India
  • Vakta Ram Choudhary Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India
  • Dinesh Bijarniya Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-2902.isj20202839

Keywords:

Complicated AA, Leukocytosis, Procalcitonin

Abstract

Background: Delay in the diagnosis of complicated appendicitis and its treatment results in an increased rate of postoperative morbidity, mortality and hospital stay. The diagnosis of appendicitis rests on a combination of signs of inflammation such as fever, pain and tenderness; leukocytosis, and elevated C-reactive protein levels, interleukin-6 (IL6) and procalcitonin. Raised level of serum procalcitonin in bacterial infection has been used to further improve the diagnosis of complicated AA.

Methods: One-hundred ten patients of appendicitis confirmed by intra-operative findings and final pathologist report, who underwent appendectomy consisting 25 women (22.73%) and 85 men (77.27%) with a mean age of 25 years (age range 15-55 years) were included in this study. Serum procalcitonin value was measured by chemi E411 Cobas method (chemilumiscent immunoassay system) using the B.R.A.H.M.S PCT kit. Serum PCT level >0.5 ng/ml was consider as risk for progression to severe systemic disease.

Results: At a 0.5 ng/dl cut-off value of PCT, the sensitivity and specificity of PCT level measurement for acute complicated appendicitis prediction was 90% and 97.14% respectively. Association between WBC count and PCT value shows the sensitivity and specificity in 40 case of acute complicated appendicitis prediction was 86% and 75% respectively.

Conclusions: Both the higher PCT values and leukocytosis correlates well with  infectious post-operative complications for acute appendicitis and it can help to carry out timely surgical intervention which is highly recommended in complicated appendicitis(correlates PCT >0.5 ng/dl).

Author Biographies

Thana Ram Patel, Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India

academic junior resident department of general surgery

Amit Jain, Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India

Associate professor, department of general surgery

Lakshman Agarwal, Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India

Senior Professor,PHOD, department of general surgery

Vakta Ram Choudhary, Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India

academic junior resident

Dinesh Bijarniya, Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India

academic junior resident

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Published

2020-06-25

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Original Research Articles