J Korean Soc Coloproctol.  2012 Oct;28(5):247-252. 10.3393/jksc.2012.28.5.247.

Hyperbilirubinemia Is a Significant Indicator for the Severity of Acute Appendicitis

Affiliations
  • 1Department of Surgery, Bundang CHA Hospital, CHA University College of Medicine, Seongnam, Korea. wehrwolf@cha.ac.kr
  • 2Department of Gastroenterology, Bundang CHA Hospital, CHA University College of Medicine, Seongnam, Korea.

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.

Keyword

Appendicitis; Appendicitis, Perforated; Appendectomy; Hyperbilirubinemia

MeSH Terms

Appendectomy
Appendicitis
Bilirubin
Biomarkers
Gilbert Disease
Humans
Hyperbilirubinemia
Leukocyte Count
Medical Records
Multivariate Analysis
Neutrophils
Retrospective Studies
Systemic Inflammatory Response Syndrome
Bilirubin
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