Dawood Kamal, Ali Akhtar, Arsalan Siraj, Irfan Shukr, Syed Hamid Ali Shah.
Accuracy of total leukocyte count and C - reactive protein in the diagnosis of acute appendicitis.
J Rawal Med Coll Jan ;14(2):75-7.

Background: To study the accuracy of CRP and TLC alone and together in diagnosis of acute appendicitis. Methods: In this cross sectional study, data was collected prospectively in 100 consecutive patients with acute appendicitis and laparatomy was performed. CRP levels more than 6mg/l and total leucocyte count more than 11X 10 9/l and , on histologic examination, neutrophilic infiltration of muscularis propria were considered positive to make a decision of acute appendicitis. Results: Sensitivity, Specificity, Positive Predictive Value(PPV),Negative Predictive Value(NPV) and Diagnostic efficacy of CRP and TLC were 93.42 %, 79.17 %, 93.42 %, 79.17%, 90 % and 53.95 %, 75 %, 87 %, 34 %, 59 % respectively. CRP and TLC together had Sensitivity 92.86 %, Specificity 88.24 %, PPV 95.12 %, NPV 83.33 % and Diagnostic efficacy 91.53 %. Difference between sensitivity and specificity of CRP and TLC was found significant (p = 0.03). Conclusion: CRP carries better diagnostic accuracy than TLC in acute appendicitis. Precision is further improved when both are considered together.

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