title: C-Reactive protein is an independent surgical indication marker for appendicitis: a retrospective study.
abstract: BACKGROUND
  This study is an attempt to clarify the role of C-reactive protein (CRP) as a surgical indication marker for appendicitis.
  
  
  METHODS
  One hundred and fifty patients who underwent appendectomies and had pathologically confirmed appendicitis were reviewed between May 1, 1999 and September 31, 2007. The correlation between preoperative clinical factors and the actual histological severity, and identify surgical indication markers were assessed by univariate and multivariate analyses.
  
  
  RESULTS
  Univariate analysis showed that only the CRP level significantly differ between the surgical treatment necessary group (gangrenous appendicitis) and the possible non-surgical treatment group (catarrhalis and phlegmonous appendicitis). Multivariate analysis indicated only the CRP level to be a surgical indication marker for acute appendicitis. The receiver-operating characteristic (ROC) curve indicated that the cutoff value of CRP for surgical indication of appendicitis is 4.95 mg/dl.
  
  
  CONCLUSIONS
  Only the CRP level is consistent with the severity of appendicitis, and considered to be a surgical indication marker for acute appendicitis.
authors.affiliation: Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan. yamaue-h@wakayama-med.ac.jp.
authors.forename: Shozo
authors.initials: S
authors.lastname: Yokoyama
authors.forename: Katsunari
authors.initials: K
authors.lastname: Takifuji
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Hotta
authors.forename: Kenji
authors.initials: K
authors.lastname: Matsuda
authors.forename: Toru
authors.initials: T
authors.lastname: Nasu
authors.forename: Mikihito
authors.initials: M
authors.lastname: Nakamori
authors.forename: Naoki
authors.initials: N
authors.lastname: Hirabayashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue