Preoperative high C-reactive protein level is associated with an increased likelihood for conversion from laparoscopic to open appendectomy in patients with acute appendicitis

Figures & data

Figure 1 Number of laparoscopic appendectomies and open appendectomies during the study period.

Abbreviations: OA, open appendectomy; LA, laparoscopic appendectomy.

Figure 2 Number of laparoscopic appendectomies and conversion from laparoscopic to open appendectomies during the study period.

Abbreviations: Conversion, conversion from laparoscopic to open appendectomy, LA, laparoscopic appendectomy.

Table 1 The characteristics before and after surgery according to the procedure

	CA G (n=9)	LA G (n=84)	p-value
Age (years)	51 (16–71)	29 (19–84)	0.07*
Gender (F/M)	1/8	37/47	0.09†
BMI	23.1 (17.9–35.6)	21.3 (15.3–30.8)	0.01*
CRP (mg/dl)	9.9 (3.6–26.0)	1.4 (0.02–21.4)	0.001*
Alb (g/dL)	4.0 (3.4–4.7)	4.4 (2.8–6.1)	0.04*
WBC (10^3/μL)	13.2 (8.3–26.5)	12.3 (4.3–22.1)	0.08*
Neutro. (%)	84.1 (77.1–95.5)	79.8 (28.8–94.6)	0.21*
Lymph (%)	6.5 (3.0–15.7)	13.6 (3.3–46.0)	0.11*
NLR	13.5 (4.9–31.8)	5.8 (0.9–27.2)	0.20*
Abscess (Y/N)	3/6	1/83	0.002†
appendicolith (Y/N)	4/5	31/53	0.73†
Histological Gangrenous (Y/N)	6/3	24/60	0.01†

Notes: Showing medians and interquartile ranges. *Tested by Mann–Whitney U-test. ^†Tested by Fisher’s exact test.

Abbreviations: BMI, body mass index; CRP, C-reactive protein; Alb, albumin; WBC, white cell count; Neutro, neutrophil; Lymph, lymphocyte; NLR, neutrophil/lymphocyte ratio; CA G, open appendectomy group; LA G, laparoscopic appendectomy group.

Table 2 The outcomes according to the procedure

	CA G (n=9)	LA G (n=84)	p-value
Operating time (mins)	121 (93–219)	59 (28–176)	0.0001*
Blood loss (g)	125 (1–300)	1 (1–150)	0.0001*
PSI (days)	5 (2–8)	2 (0–11)	0.002*
TS (days)	1 (0–7)	1 (0–41)	0.63^†
LHS (days)	10 (5–14)	5 (2–24)	0.002*
Complication (Y/N)	1/8	2/82	0.27^†
IA (Y/N)	0/9	12/72	0.59^†

Notes: Showing medians and interquartile ranges. *Tested by Mann–Whitney U-test. ^†Tested by Fisher’s exact test.

Abbreviations: CA G, open appendectomy group; LA G, laparoscopic appendectomy group; PSI, period until the start of meal intake; TS, time to surgery; LHS, length of hospital stay; IA, interval appendectomy.

Figure 3 CRP level in laparoscopic appendectomies and conversion appendectomies.

Abbreviations: CRP, C-reactive protein; CA, conversion from laparoscopic to open appendectomy; LA, laparoscopic appendectomy.

Table 3 Multivariable analysis clinical and operative factors according to the procedure

	Odd ratio	95% CI	p-value
BMI	1.15	0.93–1.42	0.21^#
CRP	1.13	1.01–1.28	0.04^#
Alb	0.55	0.10–2.94	0.48^#

Note: ^#Tested by logistic regression model analyses.

Abbreviations: BMI, body mass index; CRP, C-reactive protein; Alb, albumin.