Can common serum biomarkers predict complicated appendicitis in children?

Augusto Zani, Warwick J. Teague, Simon A. Clarke, Munther J. Haddad, Sanjeev Khurana, Thomas H F Tsang, Ramesh M. Nataraja

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: As appendicitis in children can be managed differently according to the severity of the disease, we investigated whether commonly used serum biomarkers on admission could distinguish between simple and complicated appendicitis. Methods: Admission white blood cell (WBC), neutrophil (NEU), and C-reactive protein (CRP) levels were analysed by ROC curve, and Kruskal–Wallis and contingency tests. Patients were divided according to age and histology [normal appendix (NA), simple appendicitis (SA), complicated appendicitis (CA)]. Results: Of 1197 children (NA = 186, SA = 685, CA = 326), 7% were <5 years, 55% 5–12, 38% 13–17. CA patients had higher CRP and WBC levels than NA and SA (p < 0.0001). NEU levels were lower in NA compared to SA or CA (p < 0.0001), but were similar between SA and CA (p = 0.6). CA patients had higher CRP and WBC levels than SA patients in 5–12- (p < 0.0001) and 13–17-year groups (p = 0.0075, p = 0.005), but not in <5-year group (p = 0.72, p = 0.81). We found CRP >40 mg/L in 58% CA and 37% SA (p < 0.0001), and WBC >15 × 109/L in 58% CA and 43% SA (p < 0.0001). Conclusions: Admission CRP and WBC levels may help the clinician predict complicated appendicitis in children older than 5 years of age. Early distinction of appendicitis severity using these tests may guide caregivers in the preoperative decision-making process.

Original languageEnglish
Pages (from-to)799-805
Number of pages7
JournalPediatric Surgery International
Volume33
Issue number7
DOIs
Publication statusPublished - 1 Jul 2017

Keywords

  • Blood tests
  • CRP
  • Paediatric appendicitis
  • Preoperative investigations
  • USS

Cite this

Zani, A., Teague, W. J., Clarke, S. A., Haddad, M. J., Khurana, S., Tsang, T. H. F., & Nataraja, R. M. (2017). Can common serum biomarkers predict complicated appendicitis in children? Pediatric Surgery International, 33(7), 799-805. https://doi.org/10.1007/s00383-017-4088-1
Zani, Augusto ; Teague, Warwick J. ; Clarke, Simon A. ; Haddad, Munther J. ; Khurana, Sanjeev ; Tsang, Thomas H F ; Nataraja, Ramesh M. / Can common serum biomarkers predict complicated appendicitis in children?. In: Pediatric Surgery International. 2017 ; Vol. 33, No. 7. pp. 799-805.
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abstract = "Purpose: As appendicitis in children can be managed differently according to the severity of the disease, we investigated whether commonly used serum biomarkers on admission could distinguish between simple and complicated appendicitis. Methods: Admission white blood cell (WBC), neutrophil (NEU), and C-reactive protein (CRP) levels were analysed by ROC curve, and Kruskal–Wallis and contingency tests. Patients were divided according to age and histology [normal appendix (NA), simple appendicitis (SA), complicated appendicitis (CA)]. Results: Of 1197 children (NA = 186, SA = 685, CA = 326), 7{\%} were <5 years, 55{\%} 5–12, 38{\%} 13–17. CA patients had higher CRP and WBC levels than NA and SA (p < 0.0001). NEU levels were lower in NA compared to SA or CA (p < 0.0001), but were similar between SA and CA (p = 0.6). CA patients had higher CRP and WBC levels than SA patients in 5–12- (p < 0.0001) and 13–17-year groups (p = 0.0075, p = 0.005), but not in <5-year group (p = 0.72, p = 0.81). We found CRP >40 mg/L in 58{\%} CA and 37{\%} SA (p < 0.0001), and WBC >15 × 109/L in 58{\%} CA and 43{\%} SA (p < 0.0001). Conclusions: Admission CRP and WBC levels may help the clinician predict complicated appendicitis in children older than 5 years of age. Early distinction of appendicitis severity using these tests may guide caregivers in the preoperative decision-making process.",
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Zani, A, Teague, WJ, Clarke, SA, Haddad, MJ, Khurana, S, Tsang, THF & Nataraja, RM 2017, 'Can common serum biomarkers predict complicated appendicitis in children?', Pediatric Surgery International, vol. 33, no. 7, pp. 799-805. https://doi.org/10.1007/s00383-017-4088-1

Can common serum biomarkers predict complicated appendicitis in children? / Zani, Augusto; Teague, Warwick J.; Clarke, Simon A.; Haddad, Munther J.; Khurana, Sanjeev; Tsang, Thomas H F; Nataraja, Ramesh M.

In: Pediatric Surgery International, Vol. 33, No. 7, 01.07.2017, p. 799-805.

Research output: Contribution to journalArticleResearchpeer-review

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Zani A, Teague WJ, Clarke SA, Haddad MJ, Khurana S, Tsang THF et al. Can common serum biomarkers predict complicated appendicitis in children? Pediatric Surgery International. 2017 Jul 1;33(7):799-805. https://doi.org/10.1007/s00383-017-4088-1