Hyperbilirubinemia Is a Significant Indicator for the Severity of Acute Appendicitis.
10.3393/jksc.2012.28.5.247
- Author:
Young Ran HONG
1
;
Chul Woon CHUNG
;
Jong Woo KIM
;
Chang Il KWON
;
Dae Ho AHN
;
Sung Won KWON
;
Seong Ki KIM
Author Information
1. Department of Surgery, Bundang CHA Hospital, CHA University College of Medicine, Seongnam, Korea. wehrwolf@cha.ac.kr
- Publication Type:Original Article
- Keywords:
Appendicitis;
Appendicitis, Perforated;
Appendectomy;
Hyperbilirubinemia
- MeSH:
Appendectomy;
Appendicitis;
Bilirubin;
Biomarkers;
Gilbert Disease;
Humans;
Hyperbilirubinemia;
Leukocyte Count;
Medical Records;
Multivariate Analysis;
Neutrophils;
Retrospective Studies;
Systemic Inflammatory Response Syndrome
- From:Journal of the Korean Society of Coloproctology
2012;28(5):247-252
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study aims to reveal more effective clinical or laboratory markers for the diagnosis of acute appendicitis and to score the severity based on a sufficiently large number of patients with acute appendicitis. METHODS: We identified 1,195 patients with acute appendicitis after excluding those with other causes of hyperbilirubinemia among the 1,271 patients that underwent a laparoscopic or an open appendectomy between 2009 and 2010. A retrospective chart review of the medical records, including laboratory and histologic results, was conducted. We then analyzed the data using univariate and multivariate analyses. RESULTS: Among the 1,195 patients, a laparoscopic appendectomy was performed in 685 cases (57.32%), and an open appendectomy was performed in 510 cases (42.68%). The univariate analysis demonstrated significant differences for white blood cell count (P < 0.0001), segmented neutrophils (P = 0.0035), total bilirubin (P < 0.0001), and systemic inflammatory response syndrome (SIRS) score between groups (P < 0.0001). The multivariate analysis demonstrated that total bilirubin (odds ratio, 1.772; 95% confidence interval, 1.320 to 2.379; P = 0.0001) and SIRS score (odds ratio, 1.583; 95% confidence interval, 1.313 to 1.908; P < 0.0001) have statistically significant diagnostic value for perforated appendicitis. CONCLUSION: Hyperbilirubinemia is a statistically significant diagnostic marker for acute appendicitis and the likelihood of perforation.
