Diagnostic value of lactate levels in acute appendicitis

Objective: To assess the value of lactate measurements in addition to standard diagnostic measurement of white blood cell count (WBC) and C-reactive protein (CRP) in the accuracy of preoperative acute appendicitis (AA) diagnosis. Methods: A total of thirty-six consecutive patients with histopathologically confirmed acute appendicitis were retrospectively included in the study. Fifteen volunteers were included as control group. Patient characteristics, preoperative ultrasonography (US) and laboratory assessment including WBC, C-reactive protein (CRP) and lactate values were collected. Receiver Operator Characterstics (ROC) curves for discriminant values and sensitivity, specificity, positive and negative predictive values (PPV,NPV) were calculated. Results: The male/female ratio of groups 1 and 2 were 25/11 and 9/6 respectively. Mean age: 34.13 +/- 9.6 years. Area under ROC values for lactate were found significant and discriminant value was found to be 8 mg/dl. Specificity, sensitivity, PPV and NPV calculated for lactate were as follows: 53%, 80%, 77% and 57%. Conclusions: Increased lactate levels as well as other inflammatory parameters should be considered as a diagnostic parameter in diagnosis of AA (JPMA 60:913; 2010).