Clin Pediatr | Volume 2, Issue 1 | Research Article | Open Access

Diagnostic Value of Procalcitonin and C-reactive Protein Level for Predicting Appendiceal Perforation in Children

Shaoguang Feng1#, Xin-He Lai2#, Aihe Wang1 and Weiguang Liu1 *

1Department of Pediatric Surgery, Hangzhou Children’s Hospital, China 2School of Biology and Food Science, Shangqiu Normal University, China

*Correspondance to: Weiguang Liu 

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Background: Acute appendicitis is one of the most common abdominal pains in children. Perforated appendicitis can result in a variety of potentially serious complications. The aim of this study was to evaluate the value of Procalcitonin (PCT) and C-Reactive Protein (CRP) as predictors of appendiceal perforation in children. Materials and Methods: We identified 201 children (75 female; 126 male, mean ages, 7.6 y) with histologically confirmed acute appendicitis after appendectomy between January 2015 and January 2019. Preoperative laboratory data such as CRP, White Blood Cell (WBC), PCT and part of postoperative histologic results were analyzed retrospectively. We also performed a multivariate logistic regression model to determine patient's age and laboratory tests associated with perforated appendicitis. Results: Mean plasma PCT level of all patients was 1.98 ng/mL (5.73 SD; range, 0.02 ng/mL to 64.77 ng/mL; median, 0.18 ng/mL). Children with appendiceal perforation had a mean PCT level of 6.26 ng/mL (9.39 SD; range, 0.2 ng/mL to 64.77 ng/mL; median, 3.10 ng/mL), which was significantly higher than those with non-perforated children (P=0.001). Mean CRP values were 60.24 mg/L (55.02 SD, range, 1.0 mg/L to 260 mg/L; median, 44.0 mg/L) in all patients, whereas they were significantly higher in perforated group (mean, 114.53 mg/L, 53.88 SD, range, 30 mg/L to 260 mg/L) compared with non-perforated children (P=0.001). Multivariate logistic analysis revealed that both PCT and CRP were associated with perforation (P=0.001). Area under the Receiver Operating Characteristic curve (ROC) of PCT for discriminating acute perforated appendicitis from non-perforated groups was larger than that of WBC and CRP. Conclusion: Both PCT and CRP are useful markers, and PCT is better than CRP for the diagnosis of perforated appendicitis in children.


Procalcitonin; C-reactive protein; Appendiceal perforation; Diagnosis; Children


Feng S, Lai X-H, Wang A, Liu W. Diagnostic Value of Procalcitonin and C-reactive Protein Level for Predicting Appendiceal Perforation in Children. Clin Pediatri. 2019; 2: 1018.

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