title: Do C-reactive protein level, white blood cell count, and pain location guide the selection of patients for computed tomography imaging in non-traumatic acute abdomen?
abstract: The value of abdominal computed tomography in non-traumatic abdominal pain has been well established. On the other hand, to manage computed tomography, appropriateness has become more of an issue as a result of the concomitant increase in patient radiation exposure with increased computed tomography use. The purpose of this study was to investigate whether C-reactive protein, white blood cell count, and pain location may guide the selection of patients for computed tomography in non-traumatic acute abdomen. Patients presenting with acute abdomen to the emergency department over a 12-month period and who subsequently underwent computed tomography were retrospectively reviewed. Those with serum C-reactive protein and white blood cell count measured on admission or within 24 h of the computed tomography were selected. Computed tomography examinations were retrospectively reviewed, and final diagnoses were designated either positive or negative for pathology relating to presentation with acute abdomen. White blood cell counts, C-reactive protein levels, and pain locations were analyzed to determine whether they increased or decreased the likelihood of producing a diagnostic computed tomography. The likelihood ratio for computed tomography positivity with a C-reactive protein level above 5 mg/L was 1.71, while this increased to 7.71 in patients with combined elevated C-reactive protein level and white blood cell count and right lower quadrant pain. Combined elevated C-reactive protein level and white blood cell count in patients with right lower quadrant pain may represent a potential factor that could guide the decision to perform computed tomography in non-traumatic acute abdomen.
authors: Department of Radiology, Ufuk University School of Medicine, Balgat, Ankara, Turkey. ebrusanhal@yahoo.com.
authors: E
authors: E
authors: Ozan
authors: Department of Radiology, Ufuk University School of Medicine, Balgat, Ankara, Turkey.
authors: G K
authors: GK
authors: Atac
authors: Department of Emergency Medicine, Ufuk University Faculty of Medicine, Ankara, Turkey.
authors: T
authors: T
authors: Evrin
authors: Department of Radiology, Ufuk University School of Medicine, Balgat, Ankara, Turkey.
authors: K
authors: K
authors: Alisar
authors: Department of Emergency Medicine, Ufuk University Faculty of Medicine, Ankara, Turkey.
authors: L O
authors: LO
authors: Sonmez
authors: Department of Statistics, Ufuk University Faculty of Arts and Sciences, Ankara, Turkey.
authors: A
authors: A
authors: Alhan
mesh_terms: D000006:Abdomen, Acute / Q000097:blood* / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D018579:Patient Selection; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D002097:C-Reactive Protein
keywords: Acute abdomen; C-reactive protein; Computed tomography; Pain location; White blood cell count