Comparative Study between Neopterin and Alvarado Score in the Diagnosis of Acute Appendicitis and Its Severity

Zuhair B. Kamal; Raghad E. Naji; Hiba A. Ali

doi:10.3889/oamjms.2021.5465

Authors

Zuhair B. Kamal Consultant General Surgeon, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
Raghad E. Naji Clinical Biochemistry, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
Hiba A. Ali Department of Surgery, Al-Kindy Teaching Hospital, Baghdad, Iraq

DOI:

https://doi.org/10.3889/oamjms.2021.5465

Keywords:

Neopterin and acute appendicitis, Alvarado score, neopterin and infection

Abstract

BACKGROUND: Acute appendicitis (AA) remains a complex case even for experienced surgeons. Rate of negative appendectomy is 5–40% and delayed intervention result in perforated appendicitis in 5–30% of cases.

AIM: The aim of the study was to evaluate NPT as a marker for the diagnosis of AA concerning its severity. And compare the diagnostic value of it with the ALV scoring system.

METHODS: One hundred twenty patients presented with signs and symptoms of AA and underwent appendectomy, only 84 patients proved to be AA by histopathological examination, were included in the study. Blood samples for neopterin (NPT) estimation and Alvarado (ALV) score was calculated. Control group consists of 45 healthy individual.

RESULTS: NPT levels were significantly higher in patients’ group than control with p = 0.001 at a cutoff point 5.3 nmol/L. The diagnostic accuracy of NPT was higher than ALV score. NPT sensitivity, specificity, positive predictive value, and negative predictive value were 85.4%, 76.9%, 89%, and 70%, respectively.

CONCLUSION: NPT significantly elevated in patient with AA and has a high diagnostic accuracy, with correlation to clinical features and severity of the inflammation.

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