Abstract
AIMS: To investigate the clinical characteristics of patients with first-episode acute appendicitis and explore the value of CT imaging grading combined with inflammatory markers in evaluating the cure and relapse of conservative treatment. METHODS: A retrospective cohort study was conducted to collect the clinical data of 482 patients with acute appendicitis diagnosed in the Emergency Department of the Second Affiliated Hospital of Fujian Medical University from October 2021 to February 2024. The imaging features of these patients were evaluated using Computed Tomography (CT) scans. Descriptive analysis, chi-square test, ordinal logistic regression model, Kaplan-Meier curve, and COX regression analysis were used to analyze the data. RESULTS: Elevated levels of Procalcitonin (PCT) and C-Reactive Protein (CRP) were associated with higher CT grades. Acute appendicitis patients with higher CT grades had a poor prognosis with antibiotic treatment. CT grade was a predictor of the prognosis of antibiotic treatment, and a high CT grade was an independent risk factor for relapse. CONCLUSION: CT grade combined with inflammatory markers (PCT and CRP) can effectively predict the prognosis of conservative treatment for acute appendicitis, and CT grade can be used to predict the risk of relapse.