ARE SERUM INFLAMMATORY MARKERS AGE-DEPENDENT IN ACUTE APPENDICITIS

BACKGROUND: Preoperative measurement of body inflammatory agents reduc es unnecessary appendectomies by up to 30 percent A decline in the for mation of blood leukocytes and C-reactive protein with aging may hinde r the correct diagnosis of appendicitis. STUDY DESIGN: White cell coun t and C-reactive protein were determined before appendectomy in 600 pa tients aged 0 to 5 years, 6 to 19 years, 20 to 39 years, 40 to 59 year s, 60 to 79 years, and older than 80 years. Their records were analyze d, The sensitivity, specificity, diagnostic accuracy, and receiver-ope rating characteristic curves for C-reactive protein and white cell cou nt to predict appendicitis were calculated separately for each age gro up. RESULTS: The rates of negative explorations and perforations were highest at both extremes of age. In uncomplicated appendicitis, the di agnostic potential of white cell count was better than C-reactive prot ein in all age groups except infants. The C-reactive protein was eleva ted similarly throughout human life, but only in those with perforated appendicitis. The receiver-operating characteristic curves confirmed that the performance of white cell count was better than C-reactive pr otein in the correct diagnosis in every age group except infants and o ctogenarians. CONCLUSIONS: The leukocyte response declines in 0- to 5- year-old children with appendicitis, but the C-reactive protein respon se is well preserved in all other age groups.