title: [Predictive calue of leucocyte count, neutrophil percent and C-reactive protein concentration "cut-off value" on the diagnosis of appendicitis].
abstract: BACKGROUND
  The present study aimed to investigate the predictive importance of cut-off levels of preoperative WBC, neutrophil and CRP concentrations in operated appendicitis patients.
  
  
  METHODS
  Patients operated for acute appendicitis between January 2008 and November 2010 were retrospectively screened. Patients were divided into three groups according to postoperative histopathology. Group I: normal appendix, Group II: Uncomplicated appendicitis, Group III: complicated appendicitis. ROC curves are intended for positive distinguishing pathological laboratory measurements. Cut-off values were determined and distinguishing performances were assessed.
  
  
  RESULTS
  175 of the 320 patients were males (54.7%) and 145 were females (45.3%). Average age was 35.95±14.75. While cut-off value for WBC was 12.080 and it was found significant in distinguishing total appandisitis (group II+group III) from normal appendixes and distinguishing group II from group I (p<0.001), it was determined that it was not significant in distinguishing group II from group III (p=0.768). While cut-off value for neutrophil was 73% and it was significant in distinguishing group II+group III from group I and group II from group I (p<0.001), it was detected that it was not significant in distinguishing group II from group III (p=0.681). While cut-off value for CRP was 45.98, it was not found significant in distinguishing group II+group III from group I and group II from group I; however it was significant in distinguishing group II from group III (p<0.001). When all measurements were evaluated together, it was detected that the increase in only the neutrophil percentage rised the non-complicated acute appendisitis (OR: 1.082; p<0.001), and the increase in both neutrophiles and CRP resulted in a rise in the risk of complication (OR: neutrophil=1.066; p=0.009- CRP=1.005; p=0.013).
  
  
  CONCLUSIONS
  The cut-off value of labaratuary tests may help determine the diagnosis and treatment. Especially, cut-off value of CRP may be helpful to determine the method of incision during the operation as conventional appendectomy or laparoscopic appendectomy.
authors.affiliation: Department of Emergency Medicine, Mersin University Faculty of Medicine, Mersin, Turkey.
authors.forename: Cüneyt
authors.initials: C
authors.lastname: Ayrık
authors.affiliation: Department of Emergency Medicine, Balıkesir State Hospital, Balıkesir, Turkey.
authors.forename: Ulaş
authors.initials: U
authors.lastname: Karaaslan
authors.affiliation: Department of General Surgery, Mersin University Faculty of Medicine, Mersin, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Dağ
authors.affiliation: Department of Emergency Medicine, Mersin University Faculty of Medicine, Mersin, Turkey.
authors.forename: Seyran
authors.initials: S
authors.lastname: Bozkurt
authors.affiliation: Department of Emergency Medicine, İzmir Tepecik Training and Research Hospital, İzmir, Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Toker
authors.affiliation: Department of Emergency Medicine, Niğde State Hospital, Niğde, Turkey.
authors.forename: Filiz
authors.initials: F
authors.lastname: Demir
mesh_terms: D000328:Adult; D001064:Appendicitis / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D009504:Neutrophils; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein