A Prospective Study On Significance Of Blood Markers (Total Serum Bilirubin, Pro-Calcitonin, C-Reactive Protein) In Predicting Complicated Appendicitis
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Date
2025-05
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Publisher
The Indian Society for Health and Advanced Research
Abstract
Introduction: Complicated appendicitis poses a significant diagnostic challenge, and timely identification is crucial for improved patient outcomes. While Multi-Slice Computed Tomography (MSCT) is considered the gold standard, its cost and accessibility can be limiting factors. This study evaluates the predictive value of Total Serum Bilirubin (STB), Pro-Calcitonin (PCT), and C- Reactive Protein (CRP) in diagnosing complicated appendicitis and compares their diagnostic accuracy and cost-effectiveness with MSCT. Objectives: 1. Significance of Blood Markers (Total Serum Bilirubin, Pro-calcitonin, C-reactive protein) in predicting Complicated Appendicitis. 2. To compare the cost-effectiveness, suitability, sensitivity and specificity of MSCT (Multi Slice Computed Tomography) versus Blood Markers (Total Serum Bilirubin, Pro-calcitonin, C-reactive protein) in diagnosing Complicated Appendicitis Material & Methods: This was a Prospective, single-center, comparative, observational study carried out in the Department of General Surgery, GSVM Medical College, Kanpur, Uttar Pradesh, India , between December 2022 and December 2024. The study included 100 patients presenting with clinical features of acute appendicitis. Patients were assessed using blood biomarkers (STB, PCT, CRP) alongwith MSCT scans. The sensitivity, specificity, and cost-effectiveness of these diagnostic tools were analyzed. STB, PCT, and CRP levels were significantlyResults: higher in patients with complicated appendicitis compared to uncomplicated cases. CRP demonstrated the highest sensitivity, while PCT showed the highest specificity. STB was strongly associated with appendiceal perforation and necrosis. When used in combination, these biomarkers achieved a diagnostic accuracy close to that of MSCT (92% sensitivity, 86% specificity). Given the lower cost of biomarker testing (?3500-?4000) compared to MSCT (?6000-?10,000), these markers present a cost-effective alternative in resource-limited settings. Conclusions: Blood biomarkers (STB, PCT, and CRP) provide a reliable and economical alternative to MSCT in diagnosing complicated appendicitis, particularly in settings with financial or logistical constraints.
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Keywords
Complicated Appendicitis, Serum Total Bilirubin, Pro-calcitonin, C-reactive Protein
Citation
Dubey Vivek Kumar, Singh Siddharth, Jauhari Ramendra Kumar, Mishra Yukteshwar, Sijwali Kavita. A Prospective Study On Significance Of Blood Markers (Total Serum Bilirubin, Pro-Calcitonin, C-Reactive Protein) In Predicting Complicated Appendicitis. Indian Journal Of Applied Research. 2025 May; 15(5): 23-25