Procalcitonin as a Prognostic Marker of Complicated Appendicitis

ABSTRACT

Introduction: Acute appendicitis is the most common cause of acute abdominal pain as well as one of the most frequently performed procedures in general surgery. Different prognostic laboratory markers have been studied to identify patients with complicated appendicitis and it is unknown whether the level of procalcitonin in adults could be used as a predictive marker. From a cut-off point, Does procalcitonin have predictive value for complicated appendicitis? Methods: Prospective, observational study. Patients from the Civil Hospital of Guadalajara with a diagnosis of Appendicitis, presurgical laboratory studies and Procalcitonin, and undergo appendectomy in this institution. A calculated sample was obtained based on the surgeries performed annually. Result(s) 80 appendicectomies were performed in the 12-month period (2021;COVID pandemic) obtaining 37 patients with uncomplicated appendicitis (Phase I and II) 43 patients with complicated appendicitis (Phase III and IV) The procalcitonin levels of both groups were analyzed to demonstrate differences between them, Mann-Whitney U test gives us as a result a p value <0.05. For the cut-off point at the most suitable procalcitonin level for this sample we decided to use the Yauden index method in the analysis of the ROC curve it is observed that the cut-off point with a sensitivity of 72.1% and a specificity of 81.1% for the sample is 0.305. Conclusion(s) Procalcitonin has been shown to be a useful marker for discriminating the severity of appendicitis and that the best cutoff point for this sample is 0.3 ng/dl.