TPW 9.13 Serum Biomarkers in Assessment of Severity & Grade of Acute Appendicitis (AA): A Cohort Study

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ID: 323895
2026
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Abstract
Abstract Aims Serum-biomarkers have been used to aid-diagnosis of AA in conjunction with clinical assessment & radiological imaging. Aim of study is to assess serum-biomarkers (WCC, neutrophil count & CRP) in AA severity. Methods Cohort-study was-carried-out from Jan’2020 to Jan’2026 at single-institution. Descriptive-demography & outcomes were-evaluated. AA-severity-grading was classified using descriptive-histopathological-assessment. Results Grade-0-(Normal)-(n=142) Grade-1-(Early/Simple)-(n=375) Grade-2-(Suppurative-Phlegmonous)-(n=278) Grade-3-(Gangrenous)-(n=101) Grade-4-(Perforated)-(n=76) Kruskal-Wallis-(p-value)-ANOVA Age(yrs) 36.3±1.7 35.0±0.9 37.5±1.1 41.1±2.5 45.3±2.4 <0.005 Sex(M:F) 52:90 185:190 127:151 58:43 35:41 <0.05 BMI(kg/m2) 25.5±0.5 25.5±0.4 25.9±0.4 25.5±0.6 27.2±0.6 <0.05 WCC(x109/L) 8.3±0.3 12.6±0.2 13.6±0.2 14.9±0.4 15.9±0.5 <0.0001 CRP(mg/L) 18.7±3.4 21.7±1.3 78.6±3.2 150.7±9.4 276.5±13.0 <0.0001 Neut(x109/L) 5.7±0.3 10.0±0.2 11.1±0.2 12.5±0.4 13.5±0.4 <0.0001 Op-time(mins) 66.2±2.6 69.5±1.4 76.2±2.0 84.3±3.4 97.2±4.9 <0.0001 LOS(days) 2±1 2±0.5 2±0.5 3±1.5 5±2 <0.0001 Inpatient-AB(days) 2±1 2±0.5 2±0.5 3±1.5 5±2 <0.0001 Discharge-AB(days) 0±0 0±2.5 3±2.5 5±1 5±2.5 <0.0001 Washout(n) 74 223 192 82 62 <0.0001 Drain(n) 3 0 48 40 46 <0.0001 Conclusions No single-serum-biomarker is-definitive for AA-severity, however combination assessments (symptoms, physical-examination, radiological-imaging) is crucial. Serum-biomarkers are raised progressively with AA-severity, reflected in worse-outcomes (prolonged-operation, increased-washout &-drainage, LOS, prolonged-AB-use). Novel-biomarkers such-as: LRG1, IL-6, Calprotectin, sCD40L, G-CSF Procalcitonin, I-FABP may-help in diagnosis-of-severe-AA.
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Authors M A Gok, N C McCarthy, H E Huguet, K Riaz, S Khan, U A Khan
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.411
URL
https://doi.org/10.1093/bjs/znag087.411
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