Hyperbilirubinemia Is a Significant Indicator for the Severity of Acute Appendicitis
홍영란, 정철운, 김종우, 권창일, 안대호, 권성원, 김성기,
소속 상세정보
홍영란 ( Hong Young-Ran )
CHA University College of Medicine Bundang CHA Hospital Department of Surgery
정철운 ( Chung Chul-Woon )
CHA University CHA Bundang Medical Center Department of Surgery
김종우 ( Kim Jong-Woo )
CHA University College of Medicine Bundang CHA Hospital Department of Surgery
권창일 ( Kwon Chang-Il )
CHA University College of Medicine Bundang CHA Hospital Department of Gastroenterology
안대호 ( Ahn Dae-Ho )
CHA University College of Medicine Bundang CHA Hospital Department of Surgery
권성원 ( Kwon Sung-Won )
CHA University CHA Bundang Medical Center Department of Surgery
김성기 ( Kim Seong-Ki )
CHA University College of Medicine Bundang CHA Hospital Department of Gastroenterology
KMID : 0356720120280050247
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.
키워드
Appendicitis; Appendicitis; Perforated; Appendectomy; Hyperbilirubinemia
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