Open AccessDiagnostic accuracy of inflammatory markers in patients operated on for suspected acute appendicitis: a receiver operating characteristic curve analysis
Author(s) -
Körner Hartwig,
Söreide Jon Arne,
Söndenaa Karl
Publication year - 1999
Publication title -
european journal of surgery
Language(s) - English
Resource type - Journals
eISSN - 1741-9271
pISSN - 1102-4151
DOI - 10.1080/11024159950189744
Subject(s) - medicine , receiver operating characteristic , acute appendicitis , logistic regression , appendicitis , diagnostic accuracy , area under the curve , predictive value of tests , gastroenterology , prospective cohort study , area under curve , population , surgery , environmental health , pharmacokinetics
Objective: To analyse the diagnostic accuracy of inflammatory variables in patients operated on for suspected acute appendicitis. Design: Open prospective population based study. Setting: Teaching hospital, Norway. Interventions: Appendicectomy in 544 patients with clinically suspected acute appendicitis. Main outcome measures: Diagnostic accuracy of inflammatory variables using receiver operating characteristic (ROC) curve analysis. Logistic regression model of inflammatory variables using results of ROC‐analysis. Results: A small area under the ROC curve (AUC) (between 0.56 and 0.69) indicated less diagnostic accuracy. The best cut‐off values were associated with low sensitivity and specificity, varying from 46% to 88%. Age, duration of history, and histological grade of inflammation significantly influenced the test results (AUC > 0.5). The white cell count (WCC) and C‐reactive protein (CRP) concentration were independent predictors of acute appendicitis with cut‐off values of > 12.3 × 10 9 /L and >0 mg/L, respectively, but AUC values of over 0.5 were observed only in patients between 13 and 40 years of age. Conclusion: Inflammatory variables added information of limited value in the diagnosis of suspected acute appendicitis. The test results should be interpreted differently in different groups of patients. Copyright © 1999 Taylor and Francis Ltd.