Diagnostic value of hyperfibrinogenemia as a predictive factor for appendiceal perforation in acute appendicitis

Zhao, Lingling; Feng, Shaoguang; Huang, Su; Tong, Yulong; Chen, Zhongliang; Wu, Ping; Lai, Xin‐He; Chen, Xiaoming

doi:10.1111/ans.13316

Cited by 20 publications

(15 citation statements)

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“…Also, in a study by Noh et al [ 19 ], WBC and CRP and bilirubin levels were useful clinical markers in the diagnosis of complicated appendicitis. A study by Zhao et al [ 20 ] reported that hyperfibrinogenemia might be useful as a predictive factor for appendiceal perforation. Several studies reported that hyperbilirubinemia (>1.0 mg/dL) and CRP level (>5 mg/dL) were statistically significant markers of perforation in patients with acute appendicitis [ 21 22 ].…”

Section: Discussionmentioning

confidence: 99%

Predictive Factors to Distinguish Between Patients With Noncomplicated Appendicitis and Those With Complicated Appendicitis

et al. 2015

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PurposeRecently, randomized controlled trials have reported that conservative therapy can be a treatment option in patients with noncomplicated appendicitis. However, preoperative diagnosis of noncomplicated appendicitis is difficult. In this study, we determined predictive factors to distinguish patients with noncomplicated appendicitis from those with complicated appendicitis.MethodsA total of 351 patients who underwent surgical treatment for acute appendicitis from January 2011 to December 2012 were included in this study. We classified patients into noncomplicated or complicated appendicitis groups based on the findings of abdominal computed tomography and pathology. We performed a retrospective analysis to find factors that could be used to discriminate between noncomplicated and complicated appendicitis.ResultsThe mean age of the patients in the complicated appendicitis group (54.5 years) was higher than that of the patients in the noncomplicated appendicitis group (40.2 years) (P < 0.001), but the male-to-female ratios were similar. In the univariate analysis, the appendicocecal junction's diameter, appendiceal maximal diameter, appendiceal wall enhancement, periappendiceal fat infiltration, ascites, abscesses, neutrophil proportion, C-reactive protein (CRP), aspartate aminotransferase, and total bilirubin were statistically significant factors. However, in the multivariate analysis, the appendiceal maximal diameter (P = 0.018; odds ratio [OR], 1.129), periappendiceal fat infiltration (P = 0.025; OR, 5.778), ascites (P = 0.038; OR, 2.902), and CRP (P < 0.001; OR, 1.368) were statistically significant.ConclusionSeveral factors can be used to distinguish between noncomplicated and complicated appendicitis. Using these factors, we could more accurately distinguish patients with noncomplicated appendicitis from those with complicated appendicitis.

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Section: Discussionmentioning

confidence: 99%

Predictive Factors to Distinguish Between Patients With Noncomplicated Appendicitis and Those With Complicated Appendicitis

et al. 2015

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“…These studies conclude that FB might be useful because of its positive correlation with the severity of the disease, being especially useful to differentiate uncomplicated from complicated appendicitis. [8][9][10][11][12][13][14] In our previous study of the diagnostic accuracy of FB in children of 5 to 14 years old, we showed that the CV to differentiate appendicitis from NSAP is 520 mg/dL. 14 In this study in preschool children, the diagnostic accuracy of FB is good to discriminate appendicitis from NSAP, with the CV in 520 mg/dL, the same figure than in older children.…”

Section: Discussionmentioning

confidence: 54%

“…White blood cell (WBC) count, absolute neutrophil count (ANC), and C-reactive protein (CRP) are the most studied and used in clinical practices. 7 Fibrinogen (FB) has been reported recently as a useful biomarker in the diagnosis of appendicitis, [8][9][10][11][12][13][14] but it has not been assessed specifically in the preschool age group. Since WBC and ANC in young children have a worst diagnostic accuracy to discriminate appendicitis than in older children, 7 it would be interesting to identify more useful inflammatory markers in this group of patients.…”

Section: Introductionmentioning

confidence: 99%

Value of Fibrinogen to Discriminate Appendicitis from Nonspecific Abdominal Pain in Preschool Children

et al. 2019

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Aim The aim of this study was to assess the diagnostic value of the biomarker fibrinogen (FB), along with the markers white blood cell (WBC) count, absolute neutrophil count (ANC), and C-reactive protein (CRP), to discriminate appendicitis from nonspecific abdominal pain (NSAP) in preschool children. Materials and Methods We prospectively evaluated all children aged <5 years admitted for suspected appendicitis at an academic pediatric emergency department during 5 years. Diagnostic accuracy of FB (prothrombin time–derived method), WBC, ANC, and CRP were assessed by the area under the curve (AUC) of the receiver-operating characteristic curve. Results A total of 82 patients were enrolled in the study (27 NSAP, 17 uncomplicated, and 38 complicated appendicitides). WBC and ANC had moderate diagnostic accuracy for appendicitis versus NSAP (WBC: AUC 0.66, ANC: AUC 0.67). CRP and FB had good diagnostic accuracy for appendicitis versus NSAP (CRP: AUC 0.78, FB: AUC 0.77). WBC and ANC are not useful to discriminate complicated versus uncomplicated appendicitis (WBC: AUC 0.43, ANC: AUC 0.45). CPR and FB had good diagnostic accuracy for complicated versus uncomplicated appendicitis (CRP: AUC 0.80, FB: AUC 0.73). Conclusion CRP and FB are more useful than WBC and ANC to discriminate appendicitis from NSAP in preschool children. CRP and FB are especially useful to discriminate complicated from uncomplicated appendicitis and NSAP. In a child with suspected appendicitis, a plasma FB level (prothrombin time–derived method) >540 mg/dL is associated with an increased likelihood of complicated appendicitis.

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“…Tumour cells not only directly activate the coagulation cascade by producing many procoagulant proteins (tissue factor, heparanase, cancer procoagulant, and tissue factor-positive microparticles) but also stimulate the procoagulant properties of the host's haemostatic cells (endothelial cells, platelets, and leukocytes), thereby increasing plasma Fib levels [36,37]. We also cannot exclude that the pathophysiological mechanism of hypercoagulation may be secondary to the tumour-derived systemic inflammatory response and/or intra-abdominal infectious disease [36][37][38][39].…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of preoperative plasma fibrinogen levels in primary gastrointestinal stromal tumours: a retrospective cohort study

Song

Cao

Pan

et al. 2020

Preprint

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Background Improved prediction of prognosis for gastrointestinal stromal tumours (GISTs) has become increasingly important since the introduction of small molecule tyrosine kinase inhibitors. Here, we aimed to evaluate the prognostic significance of preoperative plasma fibrinogen (Fib) levels in patients with primary GISTs and to analyse their correlations with clinicopathological characteristics. Methods A total of 201 previously untreated patients with primary GISTs who had undergone radical surgery at our institution between October 2004 and July 2018 were enrolled. Patient demographics, clinicopathological characteristics, preoperative plasma Fib levels and recurrence-free survival (RFS) were analysed. The optimal cut-off value for Fib levels was calculated using time-dependent receiver operating characteristic curve analysis. RFS, the primary endpoint, was calculated by the Kaplan–Meier method and compared by the log-rank test. Univariate and multivariate Cox regression models were calculated. Results Patients in the high Fib group had a shorter RFS than those in the low Fib group (P < 0.001). In multivariate analysis, high preoperative plasma Fib levels were detected as an independent adverse prognostic factor (P = 0.008, hazard ratio 3.136, 95% CI 1.356‒7.256). Furthermore, high preoperative plasma Fib levels also indicated a poor prognosis within the modified National Institutes of Health (mNIH) high-risk subgroup (P = 0.041). In addition, preoperative plasma Fib levels showed a positive correlation with several prognostic factors and even a linear relationship with tumour size (Spearman correlation coefficient [ r ] = 0.411, P < 0.001). Conclusions High preoperative plasma Fib levels may indicate a poor prognosis in patients with primary GISTs. As a cost-effective biomarker, preoperative assessment of plasma Fib levels may help to further risk stratify patients with mNIH high-risk GISTs and instruct the application of targeted therapy.

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Diagnostic value of hyperfibrinogenemia as a predictive factor for appendiceal perforation in acute appendicitis

Abstract: Hyperfibrinogenemia was common in patients with acute appendicitis and fibrinogen may be useful as a predictive factor for appendiceal perforation.

Cited by 20 publications

References 10 publications

Predictive Factors to Distinguish Between Patients With Noncomplicated Appendicitis and Those With Complicated Appendicitis

Predictive Factors to Distinguish Between Patients With Noncomplicated Appendicitis and Those With Complicated Appendicitis

Value of Fibrinogen to Discriminate Appendicitis from Nonspecific Abdominal Pain in Preschool Children

Prognostic significance of preoperative plasma fibrinogen levels in primary gastrointestinal stromal tumours: a retrospective cohort study

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