European Journal of Cardiovascular Medicine

Traditionally, the diagnosis of appendicitis used to make solely based on clinical signs and symptoms. Later diagnosis included results of inflammatory laboratory investigations such as leukocyte counts, neutrophil counts and CRP. This practice in diagnostics led to a false positive diagnosis (negative appendectomy) rates many times in the range of 15-30%. So, it requires more data & correlation of investigations to diagnose acute appendicitis in time. Out of the total 100 patients, who were diagnosed clinically as to have acute appendicitis, 86% of them were found to be having elevated HsCRP level and 58% presented with acute suppurative appendicitis. HsCRP test sensitivity against histopathological findings was computed to be 97.67%, specificity 85.71%, positive predictive value 97.67%, negative predictive value 85.71% and diagnostic accuracy to be 96.0%. Appendix wall thickness and HsCRP both test sensitivity was 81.40%, specificity was 42.86%, positive predictive value was 89.74%, negative predictive value was 27.27% and diagnostic accuracy was 76.0% so both HsCRP and appendix wall thickness were found to be very useful test to detect acute appendicitis. 14.0% negative appendectomies were done. Therefore, HsCRP and appendix wall thickness can be considered as a reliable diagnosis of acute appendicitis. A normal serum HsCRP level after 12 hours of onset of symptoms should be used as a basis for the decision to defer surgery to reduce the rate of negative appendicectomies, and also to reduce burden on patient as well as on health system.