Procalcitonin as an excellent differential marker between uncomplicated and complicated acute appendicitis in adult patients.

Purpose: The aim of this study was to assay the variation of procalcitonin (PCT) in adult patients with uncomplicated and complicated acute appendicitis.

Methods: In total, 336 patients who underwent appendectomy from January 2016 to December 2017 were enrolled. Levels of inflammatory markers, the highest body temperature within the first 24 h of admission (BT) and the duration of operation were recorded. All appendectomy specimens were sent for histopathological examination. According to the histopathological results, 336 patients who underwent appendectomy were divided into uncomplicated acute appendicitis (UAA) group (246 cases) and complicated acute appendicitis (CAA) group (90 cases) for further analysis. The relationships of procalcitonin (PCT) and related indicators with UAA and CAA were evaluated by receiver operating characteristic (ROC) and binary logistic regression analysis.

Results: Age, the levels of PCT, and CRP were significantly higher in CAA group (P < 0.05). Spearman correlation analysis showed that PCT was positively correlated with age (r = 0.452, P < 0.01) and CRP (r = 0.715, P < 0.01). The area under the curve (AUC) of PCT, CRP and age were 0.987, 0.902, and 0.748, respectively. ROC analysis showed when PCT > 0.42 ng/ml, it maximized the sensitivity and specificity. Logistic regression analysis indicated that PCT remained an independent risk factor for diagnosing CAA after adjusting with age and CRP (P < 0.05).

Conclusions: Serum PCT levels increased significantly in patients with CAA. PCT could provide convenient evaluation method for the optimal treatment of acute appendicitis.