Serum Procalcitonin as a Biomarker in Complicated Appendicitis - A Cross Sectional Study

Abstract

BACKGROUND Early diagnosis and treatment of acute appendicitis prevents development of markers that have been used to improve the diagnostic accuracy in appendicitis. The objective of this study was to assess the role of procalcitonin in the prediction of complications of appendicitis. METHODS A cross sectional study involving 110 patients diagnosed with acute appendicitis was conducted. After obtaining ethical clearance, informed written consent was obtained from the patients. Blood investigations such as total leucocyte counts, C reactive proteins and procalcitonin levels were done. Cases were categorized into uncomplicated appendicitis (n=67) and complicated appendicitis (n=43). Descriptive analysis, ROC analysis of predictive validity, and Shapiro Wilk test comparing all the three parameters in both the groups was done using IBM SPSS version 22. RESULTS The mean age was 29.59 ± 9.17 years. 67 (60.91%) had uncomplicated appendicitis and 43 (39.09%) had complicated appendicitis. The WBC, hsCRP, serum procalcitonin percentile had good predictive validity in predicting score as indicated by the area under the curve (0.822). Serum procalcitonin value had a sensitivity of 97.67% in predicting the type of appendicitis and specificity of 94.03%. CONCLUSIONS Serum procalcitonin is a better biomarker than total leucocyte count and hs-C reactive protein in predicting complications of appendicitis and differentiating it from uncomplicated appendicitis.