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

• Hong YR
• Chung CW
• Kim JW
• Kwon CI
• Ahn DH
• Kwon SW
• Kim SK

• KMID: 2198688
• DOI: http://doi.org/10.3393/jksc.2012.28.5.247

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