title: [Perioperative CRP quantification for appendectomy: Clinically useful or a waste of money?].
abstract: BACKGROUND
  Appendectomy is the most frequently performed non-elective surgical procedure in general surgery. Despite the questionable benefit, inflammatory markers, such as leukocyte count and C-related protein (CRP) are often determined before and after the surgical procedure. Clinicians are not infrequently confronted with the question whether a patient can be discharged despite an increase in inflammatory laboratory parameters.
  
  
  OBJECTIVE
  The aim of the current study was to retrospectively evaluate the clinical course of patients after appendectomy and the correlation with inflammatory laboratory findings.
  
  
  METHODS
  A total of 969 patients underwent a surgical procedure due to clinically suspected acute appendicitis. All clinical, laboratory and histopathological data were obtained from the patient records and a quality control database. Laboratory results were correlated with clinical and histopathological data (e.g. t-test, χ (2)-test, regression analysis and ROC curves).
  
  
  RESULTS
  In patients without acute appendicitis operative trauma caused an increase in CRP up to a median of 31 mg/dl on the first postoperative day and up to 47 mg/dl on postoperative day 2. The overall morbidity was 6.2%. The strongest predictive parameter for complications was a CRP of more than 108 mg/l on the first postoperative day with an odds ratio of 16.6 (96% CI 6.4/42.8, p < 0.001, specificity 88% and sensitivity 69%). Patients with CRP values below the threshold suffered from complications in 1.1 % of cases in contrast to patients above the threshold in 16.8% of cases (p < 0.001).
  
  
  CONCLUSIONS
  A moderate postoperative elevation of CRP values is not a general contraindication for discharge; however, postoperative determination of CRP serum values after appendectomy might be an effective predictor for complications and should therefore be measured in the clinical routine.
authors.affiliation: Klinik und Poliklinik für Allgemein-, Viszeral- und Thoraxchirurgie, Universitätsklinikums Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland, mtachezy@uke.uni-hamburg.de.
authors.forename: M
authors.initials: M
authors.lastname: Tachezy
authors.forename: I
authors.initials: I
authors.lastname: Anusic
authors.forename: S
authors.initials: S
authors.lastname: Rothenhöfer
authors.forename: F
authors.initials: F
authors.lastname: Gebauer
authors.forename: J R
authors.initials: JR
authors.lastname: Izbicki
authors.forename: M
authors.initials: M
authors.lastname: Bockhorn
mesh_terms: D000208:Acute Disease; D000328:Adult; D001062:Appendectomy; D001064:Appendicitis / Q000097:blood* / Q000175:diagnosis / Q000601:surgery*; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood* / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013223:Statistics as Topic; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein