F A Alvarez-Alvarez1, V M Maciel-Gutierrez2, A D Rocha-Muñoz3, J H Lujan4, C F Ploneda-Valencia5. 1. Department of General Surgery, Hospital Civil de Guadalajara, "Dr. Juan I. Menchaca", University of Guadalajara, Salvador de Quevedo no. 750, Guadalajara, Jalisco, Zip code 44100, Mexico. 2. Department of Colorectal Surgery, Hospital Civil de Guadalajara, "Dr. Juan I. Menchaca", University of Guadalajara, Salvador de Quevedo no. 750, Guadalajara, Jalisco, Zip code 44100, Mexico; University Center of Tonalá, University of Guadalajara, Nuevo Periférico Av. 555, Tonalá, Jalisco, Zip code 48525, Mexico. 3. University Center of Tonalá, University of Guadalajara, Nuevo Periférico Av. 555, Tonalá, Jalisco, Zip code 48525, Mexico. 4. Jackson Medical Group Specialty, 9195 Sunset Dr. Suite 230 Miami, FL, Zip code 33173, United States. 5. Department of General Surgery, Hospital Civil de Guadalajara, "Dr. Juan I. Menchaca", University of Guadalajara, Salvador de Quevedo no. 750, Guadalajara, Jalisco, Zip code 44100, Mexico. Electronic address: plonecef@gmail.com.
Abstract
BACKGROUND: Acute appendicitis (AA) has a prevalence of 8% in the general population with a rate of complicated (perforated) appendicitis (CA) up to 40%. Serum fibrinogen may serve as an indicator for CA. PATIENTS AND METHODS: 115 patients were included from January 2012 to December 2012 using a positive pathology report for AA as a gold standard diagnostic method. We divided the patients into two groups accordingly to the pathology report: Complicated Appendicitis and Uncomplicated Appendicitis (UA). Our primary endpoint was to compare the levels of serum fibrinogen between the two groups and find if there is a relationship between fibrinogen level and CA. RESULTS: 68 patients were diagnosed with UA and 47 with CA. Using a fibrinogen value of 885 mg/dl we found to be the best cut-off for predicting complicated appendicitis with a sensitivity of 86.77% (76.87-93.71 IC 95%), a specificity of 91.49 (83.51-99.46 IC 95%), a positive predictive value of 93.65 (95% CI 86.81-99.64) and, a negative predictive value of 82.69 (95% CI 65.73-87.84). CONCLUSION: In the setting of a patient with a clinical diagnosis of AA, this study demonstrates fibrinogen as a good predictor factor for appendiceal perforation.
BACKGROUND: Acute appendicitis (AA) has a prevalence of 8% in the general population with a rate of complicated (perforated) appendicitis (CA) up to 40%. Serum fibrinogen may serve as an indicator for CA. PATIENTS AND METHODS: 115 patients were included from January 2012 to December 2012 using a positive pathology report for AA as a gold standard diagnostic method. We divided the patients into two groups accordingly to the pathology report: Complicated Appendicitis and Uncomplicated Appendicitis (UA). Our primary endpoint was to compare the levels of serum fibrinogen between the two groups and find if there is a relationship between fibrinogen level and CA. RESULTS: 68 patients were diagnosed with UA and 47 with CA. Using a fibrinogen value of 885 mg/dl we found to be the best cut-off for predicting complicated appendicitis with a sensitivity of 86.77% (76.87-93.71 IC 95%), a specificity of 91.49 (83.51-99.46 IC 95%), a positive predictive value of 93.65 (95% CI 86.81-99.64) and, a negative predictive value of 82.69 (95% CI 65.73-87.84). CONCLUSION: In the setting of a patient with a clinical diagnosis of AA, this study demonstrates fibrinogen as a good predictor factor for appendiceal perforation.
Authors: G Guercio; G Augello; L Licari; A Dafnomili; C Raspanti; N Bagarella; N Falco; G Rotolo; T Fontana; C Porello; G Gulotta Journal: G Chir Date: 2016 Jul-Aug
Authors: G A Gómez-Torres; O S Ortega-Gárcia; E G Gutierrez-López; C A Carballido-Murguía; J A Flores-Rios; C R López-Lizarraga; C A Bautista López; C F Ploneda-Valencia Journal: Int J Surg Case Rep Date: 2017-05-15