Abstract
Purpose: In recent years, procalcitonin has emerged as a promising biomarker for sepsis, due to its high sensitivity and specificity. The aim of this study was to investigate the usefulness of procalcitonin as a predictor marker in the diagnosis of complicated acute appendicitis. Method: Between August 1, 2013 and December 31, 2014, a total 158 patients with acute appendicitis received laparoscopic appendectomy at our hospital. In this population, patients whose PCT was measured preoperatively were registered in this study. Severity of appendicitis was defined based on pathological findings and the patients were divided into ‘uncomplicated’ and ‘complicated’ groups. Sex, age, duration of time before admission, body temperature, absence of fecal stones or intraabdominal abscesses, white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), lactic acid levels and appendix diameter were extracted as factors of complicated appendicitis. Result: Of the 71 patients who were enrolled in this study, 27 patients were classified as having complicated appendicitis. Age, duration of time before admission, CRP, PCT, and appendix diameter were significantly higher in the complicated group. The area under the curve (AUC) of the PCT was 0.868 (95% confidence interval; 0.84 to 0.96), which was higher than the AUC for the other factors. The cut off value of PCT in the complicated group was 0.12 pg/ml and cut off value had 88.8% sensitivity, 84.1% specificity, 75% positive predictive value and 92.5% negative predictive value. Conclusion: PCT could be the most useful predictor in the diagnosis of complicated appendicitis.
