liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
Repeated clinical and laboratory examinations in patients with an equivocal diagnosis of appendicitis
Show others and affiliations
2000 (English)In: World Journal of Surgery, ISSN 0364-2313, Vol. 24, no 4, 479-485 p.Article in journal (Refereed) Published
Abstract [en]

In-hospital observation with repeated clinical examinations is commonly used in patients with an equivocal diagnosis of appendicitis. It is not known if repeated measurements of temperature and laboratory examinations have any diagnostic importance in this situation. The importance of repeated measurements of the body temperature, white blood cell (WBC) and differential cell counts, C-reactive protein concentration (CRP) and of the surgeon's repeated assessments was prospectively analyzed in 420 patients with an equivocal diagnosis of appendicitis at admission who were reexamined after a median of 6 hours of observation. The final diagnosis was appendicitis in 137 patients. After observation the inflammatory response was increasing among patients with appendicitis and decreasing among patients without appendicitis. The variables discriminating power for appendicitis consequently increased, from an area under the receiver operating characteristic (ROC) curve of 0.56 to 0.77 at admission, to 0.75 to 0.85 after observation. The ROC area of the surgeons' clinical assessment increased from 0.69 to 0.89. The WBC and differential cell counts were the best discriminators at the repeat examination. The change in the variables between the observations had weak discriminating power and had no additional importance in addition to the actual level at the repeat examination. To conclude, the diagnostic information of the temperature and laboratory examinations increased after observation. Repeated controls of the body temperature and laboratory examinations are therefore useful in the management of patients with equivocal signs of appendicitis, but the result of the examinations must be integrated with the clinical assessment.

Place, publisher, year, edition, pages
2000. Vol. 24, no 4, 479-485 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-25299DOI: 10.1007/s002689910076Local ID: 9740OAI: diva2:245627
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2011-01-14

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Nyström, Per-OlofOlaison, Gunnar
By organisation
Faculty of Health SciencesSurgeryGE: Gastrokir
In the same journal
World Journal of Surgery
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 34 hits
ReferencesLink to record
Permanent link

Direct link