Investigate diagnostic value of laboratory finding in acute appendicitis: A systematic review

Appendicitis is a common urgent surgical operation. Since early diagnosis and treatment of appendicitis is necessary and also some disease mimic its clinical manifestation and rate of negative appendectomy was high (%15-30), so surgeons were trying to increase the accuracy of diagnosis of appendicitis by using laboratory facilities. The main aims of this study were to investigation value of diagnostic findings in acute appendicitis. The review through searching in Google scholar search engine and database magiran, Sid, PubMed and iranmedex with keyword appendicitis, sensitivity, specificity and appendectomy between 1990 and 2015 was performed. The results of various studies show that the sensitivity and of WBC was from %88.6 to %98.1 and its specificity was %26.4 to %61.5. CRP sensitivity from %76 to %84.8 and its specificity from 50 to %73.4 have been reported. The sensitivity of shift to left was %90.5, and sensitivity and specificity of neutrophil and ESR was observed %93.3 and %19.2, %73.4 and %40.6 respectively. Some studies have shown that the combination of WBC and CRP tests can be helpful. The Alvarado criteria performance in grades 8 and below was lower than clinical judgment alone based on tenderness. A study showed that the revised criteria Alvarado in the diagnosis of acute appendicitis is not effective. Some other studies recommended using ultrasound method in the diagnosis of acute appendicitis due to %66 sensitivity and 94% specificity. Due to the high percentage of negative appendectomy in most studies seem to still diagnostic tests have not been defined as a standard scoring system. More researches that consider all diagnostic tests can improve diagnosis, avoid the imposition of unnecessary appendectomy and thereby result reducing in health care costs.

کلیدواژه ها:

Appendicitis ، Diagnosis ، Appendectomy ، Sensitivity ، Specificity