title: The Systemic Inflammatory Response in Patients with Appendicitis: a Progressive Phenomenon.
abstract: The systemic inflammatory response has been described in patients with appendicitis. However, its progression from onset of symptoms to diagnosis has not been characterized. The specific purpose of this study was to describe and characterize the systemic inflammatory response to appendicitis. A descriptive cross-sectional study was conducted. One hundred eighty-three patients were studied, divided into four groups from onset of symptoms to diagnosis. The primary outcome measure was to determine the systemic inflammatory response to appendicitis according to the established groups of time intervals. The secondary outcome measure was the analysis of C-reactive protein for the same purpose. The variables of the systemic inflammatory response, according to diagnostic intervals, showed non-significant differences in white blood cell count. The temperature rose constantly after 48 h, reaching its peak after 72 h (p = 0.001), and the respiratory rate rose after 73 h (p < 0.0001). After 73 h, most patients had three or four systemic inflammatory response criteria (p < 0.0001). C-reactive protein levels rose progressively, showing higher levels after 48 h (p = 0.005). The inflammatory response to appendicitis is progressive, being more marked along the timeline from onset of symptoms to diagnosis.
authors.affiliation: Department of Surgery, Hospital de La Serena, P.O. Box 912, Manuel Antonio Caro 2629, La Serena, IV Región Chile ; Emergency Unit, Hospital de La Serena, P.O. Box 912, Manuel Antonio Caro 2629, La Serena, IV Región Chile ; Departamento de Clínica, Facultad de Medicina, Universidad Católica del Norte, IV Región, Chile.
authors.forename: Marcelo A
authors.initials: MA
authors.lastname: Beltrán
keywords: Appendicitis; C-reactive protein; Inflammatory response; SIRS