BACKGROUND: Preoperative measurement of body inflammatory agents reduces unnecessary appendectomies by up to 30 percent. A decline in the formation of blood leukocytes and C-reactive protein with aging may hinder the correct diagnosis of appendicitis. STUDY DESIGN: White cell count and C-reactive protein were determined before appendectomy in 600 patients aged 0 to 5 years, 6 to 19 years, 20 to 39 years, 40 to 59 years, 60 to 79 years, and older than 80 years. Their records were analyzed. The sensitivity, specificity, diagnostic accuracy, and receiver-operating characteristic curves for C-reactive protein and white cell count to predict appendicitis were calculated separately for each age group. RESULTS: The rates of negative explorations and perforations were highest at both extremes of age. In uncomplicated appendicitis, the diagnostic potential of white cell count was better than C-reactive protein in all age groups except infants. The C-reactive protein was elevated similarly throughout human life, but only in those with perforated appendicitis. The receiver-operating characteristic curves confirmed that the performance of white cell count was better than C-reactive protein in the correct diagnosis in every age group except infants and octogenarians. CONCLUSIONS: The leukocyte response declines in 0- to 5-year-old children with appendicitis, but the C-reactive protein response is well preserved in all other age groups.
BACKGROUND: Preoperative measurement of body inflammatory agents reduces unnecessary appendectomies by up to 30 percent. A decline in the formation of blood leukocytes and C-reactive protein with aging may hinder the correct diagnosis of appendicitis. STUDY DESIGN: White cell count and C-reactive protein were determined before appendectomy in 600 patients aged 0 to 5 years, 6 to 19 years, 20 to 39 years, 40 to 59 years, 60 to 79 years, and older than 80 years. Their records were analyzed. The sensitivity, specificity, diagnostic accuracy, and receiver-operating characteristic curves for C-reactive protein and white cell count to predict appendicitis were calculated separately for each age group. RESULTS: The rates of negative explorations and perforations were highest at both extremes of age. In uncomplicated appendicitis, the diagnostic potential of white cell count was better than C-reactive protein in all age groups except infants. The C-reactive protein was elevated similarly throughout human life, but only in those with perforated appendicitis. The receiver-operating characteristic curves confirmed that the performance of white cell count was better than C-reactive protein in the correct diagnosis in every age group except infants and octogenarians. CONCLUSIONS: The leukocyte response declines in 0- to 5-year-old children with appendicitis, but the C-reactive protein response is well preserved in all other age groups.
Authors: Noel E Donlon; Michael E Kelly; Andrew Sheppard; Maria Davern; Tim S Nugent; Patrick A Boland; Kevin Corless; Waqar Khan; Iqbal Khan; Ronan Waldron; Kevin Barry Journal: Ir J Med Sci Date: 2020-09-11 Impact factor: 1.568
Authors: Pablo Ortega-Deballon; Juan C Ruiz de Adana-Belbel; Alberto Hernández-Matías; Javier García-Septiem; Mariano Moreno-Azcoita Journal: Dis Colon Rectum Date: 2008-05-17 Impact factor: 4.585
Authors: David G Bundy; Julie S Byerley; E Allen Liles; Eliana M Perrin; Jessica Katznelson; Henry E Rice Journal: JAMA Date: 2007-07-25 Impact factor: 56.272