World Journal of Emergency Surgery

unofficial impact factor 1.01

Open Access Research article

C-Reactive protein is an independent surgical indication marker for appendicitis: a retrospective study

Shozo Yokoyama, Katsunari Takifuji, Tsukasa Hotta, Kenji Matsuda, Toru Nasu, Mikihito Nakamori, Naoki Hirabayashi, Hiroyuki Kinoshita and Hiroki Yamaue*

Author Affiliations

Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan

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World Journal of Emergency Surgery 2009, 4:36 doi:10.1186/1749-7922-4-36

Published: 31 October 2009

Abstract

Background

This study is an attempt to clarify the role of C-reactive protein (CRP) as a surgical indication marker for appendicitis.

Methods

One hundred and fifty patients who underwent appendectomies and had pathologically confirmed appendicitis were reviewed between May 1, 1999 and September 31, 2007. The correlation between preoperative clinical factors and the actual histological severity, and identify surgical indication markers were assessed by univariate and multivariate analyses.

Results

Univariate analysis showed that only the CRP level significantly differ between the surgical treatment necessary group (gangrenous appendicitis) and the possible non-surgical treatment group (catarrhalis and phlegmonous appendicitis). Multivariate analysis indicated only the CRP level to be a surgical indication marker for acute appendicitis. The receiver-operating characteristic (ROC) curve indicated that the cutoff value of CRP for surgical indication of appendicitis is 4.95 mg/dl.

Conclusion

Only the CRP level is consistent with the severity of appendicitis, and considered to be a surgical indication marker for acute appendicitis.