Cargando…

Evaluation of the diagnostic value of serum level of total bilirubin in patients with suspected acute appendicitis

INTRODUCTION: Clinical diagnosis of acute appendicitis still remains a problem. Delays in diagnosis of acute appendicitis may cause perforation and septic peritonitis which result in increasing morbidity and mortality. The aim of this study was to determine the sensitivity, specificity and the diagn...

Descripción completa

Detalles Bibliográficos
Autores principales: Motie, Mohammad Reza, Nik, Minoosadat Mousavi, Gharaee, Malihe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Electronic physician 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5459271/
https://www.ncbi.nlm.nih.gov/pubmed/28607634
http://dx.doi.org/10.19082/4048
_version_ 1783241943508058112
author Motie, Mohammad Reza
Nik, Minoosadat Mousavi
Gharaee, Malihe
author_facet Motie, Mohammad Reza
Nik, Minoosadat Mousavi
Gharaee, Malihe
author_sort Motie, Mohammad Reza
collection PubMed
description INTRODUCTION: Clinical diagnosis of acute appendicitis still remains a problem. Delays in diagnosis of acute appendicitis may cause perforation and septic peritonitis which result in increasing morbidity and mortality. The aim of this study was to determine the sensitivity, specificity and the diagnostic value of total serum bilirubin levels as a predictor of acute appendicitis. METHODS: In this cross-sectional study, patients who underwent appendectomy with the diagnosis of acute appendicitis from April 2012 to March 2013 at Emam Reza Hospital in Mashhad (Iran) were enrolled. Serum bilirubin-Total and Direct-, were measured. Then based on the final pathologic reports, patients were categorized into five groups of normal appendix, chronic inflammatory changes, acute appendicitis, gangrenous and/or necrotic changes, and perforated appendicitis. Independent sample t-test, ANOVA, and Chi-square test were used for data analysis by SPSS version 16. RESULTS: There were 174 patients studied, (117 male, 57 female) with a mean age of 27.15±0.7 years. All of the patients had rebound tenderness; 75.3% had nausea, 58.6% had anorexia and 21.3% had fever. The histological reports of all patients showed 76.4% acute appendicitis. Analyzing p-values for SGPT, SGOT, WBC was (p=0.903) and differential count was (p=0.959). The study showed no significant difference between the pathological groups. However, there were no significant differences in serum total bilirubin levels between the pathological groups. Total bilirubin showed sensitivity of 48% and specificity of 61% in the diagnosis of acute appendicitis. Total serum bilirubin more than 0.85 mg/dl was the cut-off value with the best performance for diagnosis of appendicitis. CONCLUSION: Bilirubin levels are reliable, sensitive and specific to diagnosis and a prediction of complicated appendicitis.
format Online
Article
Text
id pubmed-5459271
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Electronic physician
record_format MEDLINE/PubMed
spelling pubmed-54592712017-06-12 Evaluation of the diagnostic value of serum level of total bilirubin in patients with suspected acute appendicitis Motie, Mohammad Reza Nik, Minoosadat Mousavi Gharaee, Malihe Electron Physician Original Article INTRODUCTION: Clinical diagnosis of acute appendicitis still remains a problem. Delays in diagnosis of acute appendicitis may cause perforation and septic peritonitis which result in increasing morbidity and mortality. The aim of this study was to determine the sensitivity, specificity and the diagnostic value of total serum bilirubin levels as a predictor of acute appendicitis. METHODS: In this cross-sectional study, patients who underwent appendectomy with the diagnosis of acute appendicitis from April 2012 to March 2013 at Emam Reza Hospital in Mashhad (Iran) were enrolled. Serum bilirubin-Total and Direct-, were measured. Then based on the final pathologic reports, patients were categorized into five groups of normal appendix, chronic inflammatory changes, acute appendicitis, gangrenous and/or necrotic changes, and perforated appendicitis. Independent sample t-test, ANOVA, and Chi-square test were used for data analysis by SPSS version 16. RESULTS: There were 174 patients studied, (117 male, 57 female) with a mean age of 27.15±0.7 years. All of the patients had rebound tenderness; 75.3% had nausea, 58.6% had anorexia and 21.3% had fever. The histological reports of all patients showed 76.4% acute appendicitis. Analyzing p-values for SGPT, SGOT, WBC was (p=0.903) and differential count was (p=0.959). The study showed no significant difference between the pathological groups. However, there were no significant differences in serum total bilirubin levels between the pathological groups. Total bilirubin showed sensitivity of 48% and specificity of 61% in the diagnosis of acute appendicitis. Total serum bilirubin more than 0.85 mg/dl was the cut-off value with the best performance for diagnosis of appendicitis. CONCLUSION: Bilirubin levels are reliable, sensitive and specific to diagnosis and a prediction of complicated appendicitis. Electronic physician 2017-04-25 /pmc/articles/PMC5459271/ /pubmed/28607634 http://dx.doi.org/10.19082/4048 Text en © 2017 The Authors This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/3.0/) , which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
spellingShingle Original Article
Motie, Mohammad Reza
Nik, Minoosadat Mousavi
Gharaee, Malihe
Evaluation of the diagnostic value of serum level of total bilirubin in patients with suspected acute appendicitis
title Evaluation of the diagnostic value of serum level of total bilirubin in patients with suspected acute appendicitis
title_full Evaluation of the diagnostic value of serum level of total bilirubin in patients with suspected acute appendicitis
title_fullStr Evaluation of the diagnostic value of serum level of total bilirubin in patients with suspected acute appendicitis
title_full_unstemmed Evaluation of the diagnostic value of serum level of total bilirubin in patients with suspected acute appendicitis
title_short Evaluation of the diagnostic value of serum level of total bilirubin in patients with suspected acute appendicitis
title_sort evaluation of the diagnostic value of serum level of total bilirubin in patients with suspected acute appendicitis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5459271/
https://www.ncbi.nlm.nih.gov/pubmed/28607634
http://dx.doi.org/10.19082/4048
work_keys_str_mv AT motiemohammadreza evaluationofthediagnosticvalueofserumleveloftotalbilirubininpatientswithsuspectedacuteappendicitis
AT nikminoosadatmousavi evaluationofthediagnosticvalueofserumleveloftotalbilirubininpatientswithsuspectedacuteappendicitis
AT gharaeemalihe evaluationofthediagnosticvalueofserumleveloftotalbilirubininpatientswithsuspectedacuteappendicitis