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

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.