• Wenqing Zhou, Huiying Qiao, Weiguo Yuan, Zhibing Yao, Kai Liu, Jun Wang, and Yongkui Pang.
• Department of General Surgery, The Fifth Pepple's Hospital of Wujiang Area, Suzhou, Jiangsu, People's Republic of China.
• Am J Emerg Med. 2020 Nov 1; 38 (11): 2303-2307.

BackgroundAcute appendicitis (AA) is one of the most common diseases faced by the surgeon in the emergency department. In clinical practice, how to diagnose patients with AA accurately is still challenging.MethodsWe conducted a prospective study of 84 patients who presented in the emergency department with suspected AA and measured fecal calprotectin (FC) value. The final diagnosis of AA was independently determined without reference to the test results of FC. Then, we retrospectively analyzed the FC value for identifying AA.ResultsFC value in patients with AA were significantly higher than that in patients without AA (240.5 vs. 68.5 ug/g, P < 0.001). Receiver-operating characteristic analyses demonstrated FC value to be highly sensitive and specific for the diagnosis of AA, as indicated by an overall area under the curve (AUC) of 0.928 (500 times of boot strap estimated 95% CI, 0.855-0.972), with an optimal cut off point of 106 ug/g. FC levels in 26 patients with simple AA were significantly lower than it in the 14 patients with suppurative AA (206 vs. 304ug/g, P = 0.001).ConclusionsFC test provides a sensitive, convenient and economical method to help facilitate the diagnosis of AA in emergency department. Especially for hospitals without computed tomography equipment or patients who are not suitable to exposed to radiation, FC test is of great significance for improving the diagnostic accuracy of AA.Copyright © 2019 Elsevier Inc. All rights reserved.

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