Comparison of Accuracy Value of Examination of Procalcitonin and C-reactive Protein in Pediatric Patients with Appendicitis in Central General Hospital (RSUP) H. Adam Malik and Regional General Hospital (RSUD) Dr. Pirngadi Medan
Nasution, Iqbal Pahlevi Adesaputra
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Diagnosis of acute appendicitis remains a challenge, especially in the age group of children. Delays in diagnosis lead to increased risk of serious complications such as perforation. Hence the absolute need for a diagnostic tool that is sensitive and specific. Objective to compare the accuracy values between Procalcitonin (PCT) and C-Reactive Protein (CRP) in diagnosing pediatric appendicitis. Cross-sectional study with descriptive and analytical analysis of the 31 patients under 18 years of age who present to the emergency department of RSUP H. Adam Malik with symptoms of appendicitis and appendectomy was performed from December 2014 until July 2015. Among all patients who participated in a research note that 14 (45.2%) patients with appendicitis are male and 17 (54.8%) are female, and the number of patients from the age group 12-18 years (58.1% ) more than the age group <12 years (41.9%). A CRP level in patients with acute appendicitis was increased (91.7%), and they also have elevated complications (84.2%). Sensitivity and specificity of the diagnostic test was 84.2% and 8.3% respectively, as well as the accuracy of measurement of CRP levels was 54.8%. The range of values of CRP levels were very large for acute appendicitis i.e. 0.69 to 17.10 mg / l with a mean of 10.11 ± 4.74 mg / l and for complicated appendicitis of 3.70 to 19.70 mg / l with a mean 12.27 ± 4.82 mg / l. PCT levels was found to increase (91.7%) in patients with acute appendicitis, and in patients with complicated appendicitis also increased (100%). Sensitivity and specificity of diagnostic test area 100% and 8.3% respectively and an accuracy of measurement of PCT levels is 64.5%. The range of values of PCT levels are very large for acute appendicitis is 0.04 to 55.50 ng / ml with a mean of 10.60 ± 15.95 ng / ml and for complicated appendicitis of 0.75 to 151.70 ng / ml with a mean 15.98 ± 33.44 ng / ml. Examination of PCT in patients with appendicitis had a sensitivity of 100% and a specificity of 8.3% and has a value higher accuracy (64.5%) compared with CRP examination (54.8%) with a sensitivity of 84.2% and a specificity of 8.3% , PCT and CRP had an important role in supporting the clinical diagnosis of appendicitis in children.