ABSTRACT

Aim: To determine the diagnostic accuracy of Plasma lactate and C-reactive protein in patients with acute appendicitis taking histopathology as gold standard.

Methodology: This study was conducted in department of Chemical Pathology, PGMI Lahore. Duration of study was one year. 200 suspected cases of acute appendicitis were included. Patients were categorized as with and without acute appendicitis on the basis of Lactate and c- reactive protein levels taking histopathology as gold standard. Sensitivity, specificity, positive predictive value, negative predictive value of Lactate and C-reactive protein were calculated.

Results: The mean plasma lactate levels were higher in patients with acute appendicitis when compare with subjects with no histological evidence of acute appendicitis, (p <0.001). The sensitivity and specificity of Lactate assessed by ROC curve analysis were 90.9% and 91.7%, respectively. In 60 cases with appendicitis 57(95%) had CRP ≥ 6 mg/dl while 3(5%) had CRP level < 6mg/dl. In 60 cases without appendicitis 6(10%) cases had CRP ≥ 6mg/dl and 54(90%) cases had < 6 mg/dl CRP. There was a significant difference in the frequency of raised CRP levels (≥6) among cases with and without appendicitis, p-value ≤0.001. The sensitivity, specificity, positive predictive value and negative predictive value of CRP for diagnosis of acute appendicitis were 95%, 90% and 95%, respectively.

Conclusions: The Lactate and CRP have a good diagnostic accuracy for acute appendicitis and can be used as an alternate in patients suspected of acute appendicitis.

Keywords: Appendicitis, Diagnostics trail, C-reactive protein, Lactate, Histopathology