Role of Elevation of C-Reactive Protein (Crp) as an Independent Marker for Surgical Intervention in Acute Appendicitis

Background: The treatment of acute appendicitis has been primarily by surgery .The rate of negative Appendicectomy still remains at 15–30%. This study is designed to investigate effectiveness of CRP as a surgical indication marker as well as to analyze the levels of elevation in CRP so as to identify cut offs for deciding between surgical and conservative management in Acute Appendicitis. 200 patients who underwent emergency Appendicectomy were Method: subjected to clinical examination and routine investigations including pre operative CRP and imaging studies on admission. Intra operative findings and post operative histopathology report of the specimen were also used for analysis. The HPR of each Appendicectomy specimen was used to distinguish between inflamed appendix and negative Appendicectomy and this was correlated to the pre operative levels of serum CRP of each patient to assess the level of elevation. Results: Among the 200 patients who underwent Appendicectomy, 85.5% had elevated CRP levels above 10mg/dL and the sensitivity and specificity of CRP was found to be more than those of USG and Alvarado score in diagnosing the disease. Also among the 12 patients who underwent negative Appendicectomy, CRP was normal (below 10) in more than 83%. Hence CRP is effective as a marker for surgical intervention in acute appendicitis. The best cut off value for CRP to serve this function was calculated to be 10mg/dL according to this study. Pre oper Conclusion: ative serum CRP value can be used as an independent marker for surgical intervention and the cut off value for this function is 10mg/dL.