scholarly journals Predictive Factors of Acute Complicated Appendicitis: A Retrospective Study

2021 ◽  
Author(s):  
Sawako Hiroi ◽  
Michinori Hamaoka ◽  
Masashi Miguchi ◽  
Toshihiro Misumi ◽  
Yuji Yamamoto ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Complicated Appendicitis ◽  
Fluid Retention ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Preoperative Prediction ◽  
Uncomplicated Appendicitis ◽  
Operating Characteristic Curve

Abstract Background: Complicated appendicitis is an indication for emergency surgery. Therefore, the predictive factors for appendicitis based on the patient background needs identification. Previously, factors predicting non-complicated and complicated appendicitis were reported. However, most of those reports were deemed unsuitable as a standard for emergency use, since those comprised too many items as predictors. We previously reported three items that preoperatively predicted complicated appendicitis (body temperature, C-reactive protein, and fluid retention around the appendix). In this study, we re-evaluated different cases to confirm the usefulness of these three items can for accurately predicting complicated appendicitis preoperatively. In addition, we compared the effectiveness of these predictor items with those reported by other researchers.Methods: We retrospectively evaluated 417 adult patients who underwent surgery for acute appendicitis between January 2013 and December 2019, and compared our predictor items with those used in previous reports on the preoperative prediction of complicated appendicitis (criteria A consisting of eight predictor items and criteria B consisting of seven predictor items). Results: The area under the receiver operating characteristic curve (AUC) for the sensitivity to diagnose complicated appendicitis according to our criteria, criteria A, and criteria B were 0.823, 0.839, and 0.856, respectively. The AUC of our criteria and criteria A were similar (P = 0.356); those of criteria A and B were also similar (P = 0.352). However, the AUC of criteria B was statistically higher than that of our criteria (P < 0.05).Conclusion: Diagnostic criteria B were statistically the best predictor items for characterizing complicated and uncomplicated appendicitis. However, like criteria A and B, the AUC of our criteria exceeded 0.8, and only involved three predictor items; therefore, they can be considered useful predictors.

scholarly journals Usefulness of Lymphocyte ratio and CRP Level for Early Detection of Surgical Site Infection Following spinal surgery

2019 ◽  
Author(s):  
Wenbo Wei ◽  
Shajie Dang ◽  
Dapeng Duan ◽  
Liqun Gong ◽  
Jue Wang ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Spinal Surgery ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Site Infection ◽  
C Reactive Protein ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Operating Characteristic Curve

Abstract Background: To investigate the significant laboratory markers for early diagnosis of surgical site infection after spinal surgery. And determine the diagnostic cut-off values of these markers Methods: A total of 67 patients participated in the study: 11 patients who developed surgical site infection after spinal surgery (SSI Group) and 56 patients were compared with the infected group in terms of age，gender, operating time and intraoperative blood loss (Non-SSI Group). The white blood cell (WBC) count , WBC differential , C-reactive protein (CRP) and erythrocyte sedimentation rate(ESR) were determined before and 1, 3 and 7 days postoperatively . Then, we determine the diagnostic cutoff for these markers by using the receiver operating characteristic curve. Results: The CRP, ESR and WBC were significantly higher in the SSI group at 3 and 7 days postoperatively. The lymphocyte ratio at 3 days postoperatively was significantly lower in the SSI Group. Using the receiver operating characteristic curve，lymphocyte ratio <11.5% at 3 days postoperatively (sensitivity 90.9%, specificity 75.4%, area under the curve [AUC] 0.919), and C-reactive protein level >26 mg/dL at 7 days postoperatively (sensitivity 90.9%, specificity 87.7%, area under the curve [AUC] 0.954) were the significant laboratory marker for early detection of SSI Conclusion: Lymphocyte ratio<11.5% at 3 days and C-reactive protein levels>26.5mg/dl at 7 days after spinal surgery are reliable markers of SSI.

Complications and risk factors for severe outcome in children with measles

2019 ◽  
Vol 105 (9) ◽  
pp. 896-899 ◽  
Author(s):  
Andrea Lo Vecchio ◽  
Andrzej Krzysztofiak ◽  
Carlotta Montagnani ◽  
Piero Valentini ◽  
Nadia Rossi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Retrospective Study ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Multivariable Analysis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Operating Characteristic Curve ◽  
Organ Complications

Objective and designRisk factors for severe measles are poorly investigated in high-income countries. The Italian Society for Paediatric Infectious Diseases conducted a retrospective study in children hospitalised for measles from January 2016 to August 2017 to investigate the risk factors for severe outcome defined by the presence of long-lasting sequelae, need of intensive care or death.ResultsNineteen hospitals enrolled 249 children (median age 14.5 months): 207 (83%) children developed a complication and 3 (1%) died. Neutropaenia was more commonly reported in children with B3-genotype compared with other genotypes (29.5% vs 7.7%, p=0.01). Pancreatitis (adjusted OR [aOR] 9.19, p=0.01) and encephalitis (aOR 7.02, p=0.04) were related to severe outcome in multivariable analysis, as well as C reactive protein (CRP) (aOR 1.1, p=0.028), the increase of which predicted severe outcome (area under the receiver operating characteristic curve 0.67, 95% CI 0.52 to 0.82). CRP values >2 mg/dL were related to higher risk of complications (OR 2.0, 95% CI 1.15 to 3.7, p=0.01) or severe outcome (OR 4.13, 95% CI 1.43 to 11.8, p<0.01).ConclusionThe risk of severe outcome in measles is independent of age and underlying conditions, but is related to the development of organ complications and may be predicted by CRP value.

The use of the ratio of C-reactive protein to albumin for the diagnosis of complicated appendicitis in children

2020 ◽  
Author(s):  
Wei Feng ◽  
Qian-Yu Yang ◽  
Xu-Feng Zhao ◽  
Miao-Miao Li ◽  
Hua-Lei Cui
Keyword(s):  
Operating Characteristic ◽  
Characteristic Curve ◽  
Prognostic Score ◽  
Area Under The Curve ◽  
Complicated Appendicitis ◽  
Symptom Duration ◽  
Specific Marker ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Independent Risk Factors

Abstract Background: No reliably specific marker for complicated appendicitis has been identified. The ratio of serum C-reactive protein (CRP) to albumin (ALB) (CRP/ALB ratio) is a new inflammation-based prognostic score that is associated with the severity of inflammation. However, its value in the diagnosis of complicated appendicitis has not been studied. The aim of this study was to evaluate the predictive value of the CRP/ALB ratio for the diagnosis of complicated appendicitis in children. Methods: A retrospective study of 232 children with acute appendicitis was conducted with assessments of age, sex, symptom duration, albumin and routine blood indexes on admission. According to intraoperative findings and postoperative pathological results, patients were divided into a simple appendicitis group (127 patients) and a complicated appendicitis group (105 patients). SPSS version 17 was used to analyse the data. Results: Of the 232 patients, 118 (50.9%) were male and 114 (49.1%) were female. The CRP/ALB ratio was higher in complicated appendicitis than in simple appendicitis (p<0.05). Logistic regression analysis showed that higher levels of mononuclear cell count (MC), CRP, procalcitonin (PCT) and CRP/ALB ratio were independent risk factors for complicated appendicitis in children. Receiver operating characteristic curve analysis showed that the area under the curve of the CRP/ALB ratio (0.946) was larger than that of MC (0.619), CRP (0.906) and PCT (0.843). A CRP/ALB ratio >1.43 was found to be a significant marker in the prediction of complicated appendicitis, with 91.4% sensitivity and 90.6% specificity. Patients with a CRP/ALB ratio >1.43 had a 102.22 times higher chance of having complicated appendicitis (95% CI: 41.322 - 252.874) than those with a CRP/ALB ratio ≤1.43. Conclusion: The admission CRP/ALB ratio was significantly higher in children with acute complicated appendicitis. The CRP/ALB ratio is a novel but promising haematological marker that aids in the differentiation of acute complicated and simple appendicitis.

scholarly journals Relationship between serum angiopoietin-like 4 levels and recurrence of atrial fibrillation

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098839
Author(s):  
Zhongping Ning ◽  
Xinming Li ◽  
Xi Zhu ◽  
Jun Luo ◽  
Yingbiao Wu
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
High Sensitivity ◽  
Peroxisome Proliferator ◽  
C Reactive Protein ◽  
Peroxisome Proliferator Activated Receptor ◽  
Reactive Protein ◽  
New Onset

Objective To investigate the association between serum angiopoietin-like 4 (ANGPTL4) levels and recurrence of atrial fibrillation (AF) after catheter ablation. Methods This retrospective study recruited patients with AF undergoing catheter ablation and they were divided into two groups (new-onset AF group and recurrent AF group). Demographic, clinical, and laboratory parameters were collected. Results A total of 192 patients with AF were included, including 69 patients with recurrence of AF. Serum ANGPTL4 levels were lower in patients with recurrent AF than in those with new-onset AF. Serum ANGPTL4 levels were positively correlated with superoxide dismutase and peroxisome proliferator-activated receptor γ, and negatively correlated with the CHA2DS2-VASC score, left atrial diameter, and levels of brain natriuretic peptide, malondialdehyde, high-sensitivity C-reactive protein, and interleukin-6. The receiver operating characteristic curve showed that the best cut-off for recurrent AF was serum ANGPTL4 levels  < 19.735 ng/mL, with a sensitivity and specificity of 63.9% and 74.5%, respectively. Serum ANGPTL4 levels were significantly associated with recurrence and new onset of AF (odds ratio, 2.241; 95% confidence interval, 1.081–4.648). Conclusions Serum ANGPTL4 levels are lower in patients with recurrent AF than in those with new-onset AF, and are associated with cardiac hypertrophy, oxidative stress, and inflammation.

scholarly journals A Comparison of Eosinopenia and C-Reactive Protein as a Marker of Bloodstream Infections in Critically Ill Patients: A Case Control Study

2009 ◽  
Vol 37 (3) ◽  
pp. 450-456 ◽  
Author(s):  
K. M. Ho ◽  
S. C. Towler
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Bloodstream Infections ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Receiver Operating

Diagnosis of bloodstream infections in critically ill patients is difficult. This case control study involved a total of 22 patients with confirmed bloodstream infections and 44 concurrent controls from an intensive care unit in Western Australia. We aimed to assess whether eosinopenia and C-reactive protein are useful markers of bloodstream infections in critically ill patients. The patients with bloodstream infections had a more severe disease and a longer length of intensive care unit (10.7 vs 4.0 days, P=0.001) and hospital stay (40.9 vs 17.9 days, P=0.015) than the controls. Univariate analyses showed that C-reactive protein (area under the receiver operating characteristic curve 0.847, 95% confidence internal (CI) 0.721 to 0.973), eosinophil counts (area under the receiver operating characteristic curve 0.849, 95% CI 0.738 to 0.961) and fibrinogen concentrations (area under the receiver operating characteristic curve 0.730, 95% CI 0.578 to 0.882) were significant markers of bloodstream infections. C-reactive protein concentration was, however, the only significant predictor in the multivariate analysis (odds ratio 1.21 per 10 mgH increment, 95% CI 1.01 to 1.39, P=0.007). C-reactive protein concentration appears to be a better marker of bloodstream infections than eosinopenia in critically ill patients. A large prospective cohort study is needed to assess whether eosinopenia is useful in addition to C-reactive protein concentrations as a marker of bloodstream infections.

scholarly journals The Role of Serum Fibrinogen in Predicting Reinfection after DAIR (debridement, antibiotics, and implant retention) Treatment of Periprosthetic Joint Infections

2021 ◽  
Author(s):  
Dacheng Zhao ◽  
He Jinwen ◽  
Wang Xingwen ◽  
Zhao Xiaobing ◽  
Bin Geng ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Joint Infection ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Joint Infections ◽  
Implant Retention

Abstract Background Fibrinogen (FIB) has been used to differentiate periprosthetic joint infection (PJI) from aseptic loosening. The purpose of this study was to evaluate the diagnostic value of FIB in predicting postoperative reinfection in patients with debridement, antibiotics and implant retention (DAIR). Methods We retrospectively analyzed the patients who were admitted to DAIR from January 2013 to August 2019 for consideration of PJI readmission. Subgroups were divided into subgroups based on whether there was reinfection after DAIR treatment, and the diagnostic value of serum fibrinogen, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) before DAIR treatment was analyzed by receiver operating Characteristic curve (ROC). To evaluate the diagnostic value of FIB in predicting postoperative reinfection in DAIR patients. Results FIB expression was different in acute PJI patients and chronic PJI patients treated with DAIR (4.03 VS 3.08; P < .05, 4.28 VS 3.68; P < .05). In patients with acute PJI treated with DAIR, the sensitivity and specificity of FIB were 81.82% and 83.33%, respectively, significantly higher than CRP (sensitivity, 72.73%; Specificity, 50%; P < .05), while the specificity was higher than ESR (specificity,41.67%; P < .05). In patients with chronic PJI treated with DAIR, the sensitivity and specificity of FIB were 80.00% and 66.66%, respectively, significantly higher than CRP (sensitivity, 53.33%; Specificity, 66.66%; P < .05), ESR (sensitivity was 66.00%; Specificity, 16.66 %; P < .05). Conclusion FIB can predict reinfection after DAIR treatment for acute or chronic PJI. Considering the low success rate of DAIR treatment for chronic PJI, it should be chosen carefully.

scholarly journals Comparison of sPLA2IIA performance with high-sensitive CRP neutrophil percentage PCT and lactate to identify bacterial infection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Toh Leong Tan ◽  
Christabel Wan-li Kang ◽  
Kai Shen Ooi ◽  
Swee Thian Tan ◽  
Nurul Saadah Ahmad ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Serum Levels ◽  
C Reactive Protein ◽  
Middle Income ◽  
Antibiotic Overuse ◽  
Reactive Protein ◽  
Neutrophil Percentage ◽  
Patient Arrival

AbstractEarly bacterial infection (BI) identification in resource-limiting Emergency Departments (ED) is challenging, especially in low- and middle-income counties (LMIC). Misdiagnosis predisposes to antibiotic overuse and propagates antimicrobial resistance. This study evaluates new emerging biomarkers, secretory phospholipase A2 group IIA (sPLA2-IIA) and compares with other biomarkers on their performance characteristic of BI detection in Malaysia, an LMIC. A prospective cohort study was conducted involving 151 consecutive patients admitted to the ED. A single measurement was taken upon patient arrival in ED and was analysed for serum levels of sPLA2-IIA, high-sensitive C-reactive protein (CRP), procalcitonin (PCT), neutrophil percentage (N%), and lactate. All biomarkers’ performance was compared for the outcomes using area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity. The performance of sPLA2-IIA (AUROC 0.93 [95% CI: 0.89–0.97]; Sn 80% [95% CI: 72–87]; Sp 94% [95% CI: 81–89]) was the highest among all. It was comparable with high-sensitive CRP (AUROC 0.93 [95% CI: 0.88–0.97]; Sn 75% [95% CI: 66–83]; Sp 91 [95% CI: 77–98]) but had a higher Sn and Sp. The sPLA2-IIA was also found superior to N%, PCT, and lactate. This finding suggested sPLA2-IIA was recommended biomarkers for BI detection in LMIC.

scholarly journals Immature granulocyte percentage for prediction of sepsis in severe burn patients: a machine leaning-based approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kibum Jeon ◽  
Nuri Lee ◽  
Seri Jeong ◽  
Min-Jeong Park ◽  
Wonkeun Song
Keyword(s):  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Burn Patients ◽  
Severe Burn ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Laboratory Test Results ◽  
Partial Dependence ◽  
Receiver Operating

Abstract Background Of the existing sepsis markers, immature granulocytes (IG) most frequently reflect the presence of an infection. The importance of IG as an early predictor of sepsis and bacteremia is evaluated differently for each study. This study aimed to evaluate the effectiveness of the Sysmex XN series’ IG% as an independent prognostic indicator of sepsis using machine learning. Methods A total of 2465 IG% results from 117 severe burn patients in the intensive care unit of one institution were retrospectively analyzed. We evaluated the IG% for sepsis using the receiver operating characteristic, logistic regression, and partial dependence plot analyses. Clinical characteristics and other laboratory markers associated with sepsis, including WBC, procalcitonin, and C-reactive protein, were compared with the IG% values. Results Twenty-six of the 117 patients were diagnosed with sepsis. The median IG% value was 2.6% (95% CI: 1.4–3.1). The area under the receiver operating characteristic curve was 0.77 (95% CI: 0.78–0.84) and the optimal cut-off value was 3%, with a sensitivity of 76.9% and specificity of 68.1%. The partial dependence plot of IG% on predicting sepsis showed that an IG% < 4% had low predictability, but increased thereafter. The interaction plot of IG% and C-reactive protein showed an increase in sepsis probability at an IG% of 6% and C-reactive protein of 160 mg/L. Conclusions IG% is moderately useful for predicting sepsis. However, since it can be determined from routine laboratory test results and requires no additional intervention or cost, it could be particularly useful as an auxiliary marker.

Erythrocyte sedimentation rate and C-reactive protein compared in the elderly.

1989 ◽  
Vol 35 (3) ◽  
pp. 466-468 ◽  
Author(s):  
P R Katz ◽  
S I Gutman ◽  
G Richman ◽  
J Karuza ◽  
W R Bartholomew ◽  
...  
Keyword(s):  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
The Elderly ◽  
C Reactive Protein ◽  
Predictive Values ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Sensitivity Specificity

Abstract The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) concentrations were studied in 101 elderly individuals (mean age 72 y) to determine their utility as diagnostic aids in subjects with underlying infection/inflammation. Whereas ESR and CRP were both significantly increased in patients with infection or inflammation, or both, analysis of variance indicated that those subjects still alive six months later had significantly lower ESR values. Analysis of sensitivity, specificity, and positive predictive values indicated that neither test satisfactorily discriminated between patients with and those without ongoing active or chronic disease. Receiver-operating characteristic curve analysis confirmed the low true-positive/false-positive ratios of both ESR and CRP. In the elderly, neither CRP nor ESR has distinct advantages over the other, and both tests evidently have limited utility.

scholarly journals Perforation rate after a diagnosis of uncomplicated appendicitis on CT

BJS Open ◽  
2021 ◽  
Vol 5 (1) ◽  
Author(s):  
K Lastunen ◽  
A Leppäniemi ◽  
P Mentula
Keyword(s):  
Acute Appendicitis ◽  
Emergency Operation ◽  
Patient Characteristics ◽  
Complicated Appendicitis ◽  
C Reactive Protein ◽  
Perforation Rate ◽  
Reactive Protein ◽  
Hourly Rate ◽  
Uncomplicated Appendicitis ◽  
Uncomplicated Acute Appendicitis

Abstract Background Appendicectomy is a common emergency operation. The aim of this analysis was to study the effect of preoperative delay on disease progression, and whether a novel scoring system (Atema score) could be useful in predicting complicated appendicitis. Methods Patients with uncomplicated acute appendicitis on CT and who underwent appendicectomy in 2014–2015 were analysed for patient characteristics, preoperative delay and outcomes. Results Of 837 patients with uncomplicated appendicitis on CT, 187 (22.3 per cent) were found to have complicated appendicitis at surgery. The median time estimate for perforation was 25.4 h after CT, with an hourly rate of perforation of 2 per cent. Patients with an Atema score of 6 or less and those with no appendicolith on CT and a C-reactive protein level below 51 mg/l were the slowest to develop perforation, reaching a perforation rate of 5 per cent in 7.1 and 7.6 h respectively. Conclusion A substantial proportion of patients with uncomplicated acute appendicitis on CT have complicated appendicitis at surgery. However, in patients with no risk factors, surgery can be postponed safely for up to 7 h.

Sign in / Sign up

Export Citation Format

Share Document