PURPOSE: To compare the performance for the prediction of perforated appendicitis of total bilirubin versus C-reactive protein (CRP), white blood cell count, the time period of symptoms' evolution, and systemic inflammatory response syndrome (SIRS). METHODS: Prospective observational study, applying receiver operating characteristics curve analysis to compare the sensitivity and specificity of the tested variables. RESULTS: The period of symptom's evolution was prolonged (105.2 ± 79.3 hours vs. 38.6 ± 17.5 hours), and CRP levels were higher in perforated appendicitis (176 ± 82.6 mg/l vs. 80 ± 76 mg/l). Most patients with perforated appendicitis had a SIRS score higher than 3 points. CRP (>76.7 mg/l), the time period of symptoms' evolution (>34.5 hours), and SIRS (3 points or more), were the best cutoff values to predict perforated appendicitis. CONCLUSIONS: Perforated appendicitis may be suspected based on CRP, SIRS and the time period of symptoms' evolution. We do not recommend the use of total bilirubin to predict perforation in appendicitis.
PURPOSE: To compare the performance for the prediction of perforated appendicitis of total bilirubin versus C-reactive protein (CRP), white blood cell count, the time period of symptoms' evolution, and systemic inflammatory response syndrome (SIRS). METHODS: Prospective observational study, applying receiver operating characteristics curve analysis to compare the sensitivity and specificity of the tested variables. RESULTS: The period of symptom's evolution was prolonged (105.2 ± 79.3 hours vs. 38.6 ± 17.5 hours), and CRP levels were higher in perforated appendicitis (176 ± 82.6 mg/l vs. 80 ± 76 mg/l). Most patients with perforated appendicitis had a SIRS score higher than 3 points. CRP (>76.7 mg/l), the time period of symptoms' evolution (>34.5 hours), and SIRS (3 points or more), were the best cutoff values to predict perforated appendicitis. CONCLUSIONS: Perforated appendicitis may be suspected based on CRP, SIRS and the time period of symptoms' evolution. We do not recommend the use of total bilirubin to predict perforation in appendicitis.
Entities:
Keywords:
Acute appendicitis; Hepatic dysfunction in sepsis; Hyperbilirubinaemia; Perforated appendicitis
Authors: T Eren; E Tombalak; I A Ozemir; M Leblebici; S Ziyade; O Ekinci; O Alimoglu Journal: Eur J Trauma Emerg Surg Date: 2015-08-08 Impact factor: 3.693