Hyperbilirubinaemia: its utility in non‐perforated appendicitis

Sandstrom, Anna; Grieve, David A.

doi:10.1111/ans.13373

Cited by 10 publications

(15 citation statements)

References 14 publications

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“…One limitation of this study is that it is retrospective and includes a relatively small sample size. However, this is consistent with several retrospective studies of appendixes that analyzed fewer than 200 subjects [ 20 21 22 ]. Another large-scale, multicenter study may yield further outcomes.…”

Section: Discussionsupporting

confidence: 91%

Effect of surgical timing and outcomes for appendicitis severity

Kim

Cho

2016

Ann Surg Treat Res

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PurposeThis study was aimed to evaluate the effect of time of surgery for acute appendicitis on surgical outcomes to optimize the timing of appendectomies.MethodsMedical records of patients who underwent an appendectomy were reviewed to obtain data on time of symptom onset, time of hospital presentation, and start times of surgery. Surgical findings were used to define appendicitis as either uncomplicated or complicated. The uncomplicated group included patients with simple, focal, or suppurative appendicitis, and the complicated group included patients with gangrenous, perforated appendicitis or periappendiceal abscess formation. The 2 groups were analyzed by age, sex, and time.ResultsA total of 192 patients were analyzed. The mean time from symptom onset to start of operation showed a significant difference between both groups (1,652.9 minutes vs. 3,383.8 minutes, P < 0.001). The mean time from hospital visit to start of operation showed no difference between both groups (398.7 minutes vs. 402.0 minutes, P = 0.895). Operating within 24 hours of symptom onset had a relative risk of 1.738 (95% confidence interval, 1.319–2.425) for complications. Operating more than 36 hours after symptom onset was associated with an increased risk of postoperative ileus and a longer hospital stay.ConclusionComplicated appendicitis is associated with a delay in surgery from symptom onset rather than a delay at hospital arrival. Surgeons should take into account the time from symptom onset when deciding on the timing of appendectomy. We recommend that appendectomy be performed within 36 hours from symptom onset.

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Section: Discussionsupporting

confidence: 91%

Effect of surgical timing and outcomes for appendicitis severity

Kim

Cho

2016

Ann Surg Treat Res

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“…In the current study, the sensitivity of direct bilirubin in detecting complicated appendicitis was 98.17%. Sandstrom et al [12] reported that similar to the literature, the bilirubin values provided more significant results in complicated appendicitis than CRP and leukocytes, but the PPV values were higher in AUA cases. Eddama et al [2] found that bilirubin, leukocyte, and CRP were correlated with each other in AUA, but the same correlation was not observed in individuals with normal pathology findings and those with complicated appendicitis.…”

Section: Discussionsupporting

confidence: 55%

External validation of the AppendistatTM score and comparison with CRP levels for the prediction of complicated appendicitis

Birben¹

2020

Ulus Travma Acil Cerrahi Derg

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BACKGROUND:In acute appendicitis, the treatment approach may vary depending on the age and comorbidities of the patient and whether the appendix is complicated. In this study, we validated the appendistat TM score, including the logistic regression model of complicated appendicitis, and compared the efficacy of this scoring with C-reactive protein in predicting complicated appendicitis.METHODS: Demographic characteristics, pathology, and laboratory results of patients who underwent appendectomy for acute appendicitis were retrospectively screened, those over 18 years of age were included in the study. The appendistat TM scores, including the logistic regression model of complicated appendicitis, were obtained. RESULTS:Complicated appendicitis was present in 13 (10.1%) patients and non-complicated appendicitis in 116 (89.9%). Two (15.4%) of the complicated appendicitis cases were female and 11 (84.6%) were male. The mean age of complicated appendicitis cases was 44 (20-77) years, and their median value of C-reactive protein was 41.00 mg/L. In the ROC curve analysis, the cut-off value for C-reactive protein was 23.5 mg/L and that of the appendistat TM as 9.6. The area under the curve values of the appendistat TM score and C-reactive protein were 0.787 and 0.750, respectively. CONCLUSION:Appendistat TM is a successful scoring system that contains appropriate parameters. However, C-reactive protein detecting or excluding complicated appendicitis at a similar rate to Appendistat TM suggests that the latter does not have a significant advantage in clinical practice.

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“…We set cut-off scores for WBC count, CRP level, fever, and total serum bilirubin level at 11,000/μL, 0.5 mg/dL, 37.3°C, and 1.1 mg/dL, respectively, based on previous reports. 3,7,8…”

Section: Methodsmentioning

confidence: 99%

Hyperbilirubinemia as a predictor of severity of acute appendicitis

et al. 2019

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Objective This study aimed to investigate the clinical significance of preoperative hyperbilirubinemia in Japanese patients and to assess its clinical potential as a predictor of the severity of acute appendicitis. Methods We studied 318 patients with appendicitis who underwent appendectomy between July 2010 and June 2017. We analyzed preoperative data including age, sex, white blood cell count, C-reactive protein (CRP) level, fever, peritoneal irritation signs, and serum total bilirubin level as potential risk factors for complicated (perforated or gangrenous) appendicitis, using multivariate analysis. Results Complicated appendicitis was significantly more frequent in patients with hyperbilirubinemia (>1.1 mg/dL), high CRP level (>0.5 mg/dL), positive peritoneal irritation signs, and fever (>37.3°C). Multivariate analysis revealed older age (>64 years), hyperbilirubinemia, high CRP level, and fever (odds ratios 3.36, 1.75, 7.61, and 2.43, respectively) as risk factors for complicated appendicitis. Multivariate analysis also identified hyperbilirubinemia, high CRP level, and fever (odds ratios 1.99, 5.90, and 2.72, respectively) as risk factors for complicated appendicitis among patients aged <65 years. Conclusions Hyperbilirubinemia, high CRP level, and fever may be useful predictors of the severity of acute appendicitis, with hyperbilirubinemia being especially useful among patients aged <65 years.

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Hyperbilirubinaemia: its utility in non‐perforated appendicitis

Abstract: Bilirubin had a higher specificity than CRP and WCC overall in patients with appendicitis. Hyperbilirubinaemia had a high PPV in patients with simple appendicitis.

Cited by 10 publications

References 14 publications

Effect of surgical timing and outcomes for appendicitis severity

Effect of surgical timing and outcomes for appendicitis severity

External validation of the AppendistatTM score and comparison with CRP levels for the prediction of complicated appendicitis

Hyperbilirubinemia as a predictor of severity of acute appendicitis

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