Is Procalcitonin a Reliable Prognostic Value in the Complicated Appendicitis? a Prospective Study and Literature Review; [آیا پروکلسیتونین یک معی ار تشخیصی قابل اعتماد در شناسایی آپاندیسیت عارض هدار میباشد؟ مطالعه کوهورت آیندهنگر] Publisher



Rezapanah A ; Koushki J ; Lamcechi N ; Dalili A ; Sarkardeh M
Source: Journal of Isfahan Medical School Published:2026

Abstract

Background Regarding the importance of early diagnosis of acute appendicitis and preventing mortality and morbidity due to late diagnosis of this disease, the study aims to evaluate the diagnostic effect of procalcitonin as a biomarker for complicated appendicitis. Methods: This prospective and cross-sectional study was conducted on patients referred to Imam Reza Hospital in Mashhad from 2020-2021 with a clinical diagnosis of acute appendicitis. To obtain the necessary information for this study, all the information was collected based on the existing questionnaire. Findings: A total of 123 patients (64 males and 59 females) with an average age of 31.45 ± 10.60 years were included in the study. The most common signs and symptoms of patients were right lower quadrant (RLQ) tenderness and pain migration to RLQ, which were present in 122 patients (99.2%) and 116 patients (94.3%), respectively. Increased C-reactive protein (CRP) was observed in all patients, but increased procalcitonin and neutrophilia were present in 33.9% and 54.5% of patients, respectively. in procalcitonin, the sensitivity and specificity for distinguishing complicated from uncomplicated appendicitis were equal to 100% and 92.7%, in CRP were equal to 100% and 0%, in ultrasound were equal to 100% and 73.3% and finally in Alvarado score were equal to 86.7% and 16%. Conclusion: Although Procalcitonin does not have high sensitivity in diagnosing acute appendicitis, it may have specificity to recognize complicated appendicitis. © 2026, Isfahan University of Medical Sciences(IUMS). All rights reserved.