eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
Current issue Archive Manuscripts accepted About the journal Supplements Editorial board Reviewers Subscription Contact Instructions for authors Ethical standards and procedures
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank
Search
Editorial Policies
Sarajevo Declaration on Integrity and Visibility of Scholarly Publications
1/2020
vol. 15
 
Share:
Send email
Share:
abstract:
Original paper

Serum bilirubin concentration as a marker of severity of acute appendicitis

Maciej Jastrzębski
1
,
Maciej Krasnodębski
1
,
Michalina Szczęśniak
1
,
Michał Wierzchowski
1
,
Julia Pikul
1
,
Dariusz Jabłoński
2
,
Michał Grąt
1
,
Tadeusz Wróblewski
1
,
Krzysztof Zieniewicz
1

  1. Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
  2. Public Central Teaching Hospital, Warsaw; Poland
Videosurgery Miniinv 2020; 15 (1): 117–122
DOI: https://doi.org/10.5114/wiitm.2019.87140
Online publish date: 2019/08/22
View full text Get citation
 
PlumX metrics:
Introduction
Acute appendicitis (AA) is one of the most common causes of urgent admission to the hospital. Clinically applicable classification distinguishes simple and complex inflammation. Among commonly used inflammation markers of AA, bilirubin concentration is not well studied and thus is rarely applied.

Aim
To examine the association between increased serum total bilirubin concentration and the severity of AA.

Material and methods
This retrospective study included 169 patients with a presumptive diagnosis of AA who were operated upon between 2015 and 2017. The determined study endpoints were simple complex inflammation and a different diagnosis after surgery. The Mann-Whitney U, Kruskal-Wallis, Fisher’s exact, Spearman correlation coefficient and logistic regression tests and receiver-operating characteristics (ROC) were used in analyses. The area under the curve (AUC) was presented with 95% confidence intervals (95% CIs). Statistical significance was set at 0.05.

Results
In total, 84 (49.7%) patients underwent laparotomy and 85 (50.3%) laparoscopy. After surgery, 45 (26.6%) patients had a diagnosis other than AA. Furthermore, 83 (49.1%) and 41 (24.3%) patients had simple and complex AA, respectively. The median bilirubin concentration was 0.56, 0.69, and 1.08 mg/dl in patients without AA, with simple, and complex AA, respectively (p < 0.01). The optimal cut-off for serum bilirubin concentration to predict AA severity was ≥ 0.94 mg/dl (AUC = 0.652; 95% CI: 0.543–0.761) with a 44.9% positive and 83.9% negative predictive value (p = 0.006).

Conclusions
The serum bilirubin concentration should be considered as one of the possible markers of AA. Moreover, it can be used to predict the severity of AA.

keywords:

laparoscopic appendectomy, acute appendicitis, serum bilirubin concentration, complex appendicitis
  
Termedia
About us Contact
Copyright notice Privacy policy Advertising policy Contact us
Quick links
Journals Books eBooks Events
© 2024 Termedia Sp. z o.o.
Developed by Bentus.