Hyperbilirubinaemia alone cannot distinguish a perforation in acute appendicitis.

Autor: Silva FR; Medical Residency, São José Hospital, Criciuma, Santa Catarina, Brazil., da Rosa MI; Postgraduate Program in Health Sciences, Laboratory of Epidemiology, University of Extremo Sul Catarinense, Criciuma, Santa Catarina, Brazil., Silva BR; Medical Residency, Laboratory of Epidemiology, University of Extremo Sul Catarinense, Criciuma, Santa Catarina, Brazil., Simon C; Scientific Initiation Scholarship FUMDES, Laboratory of Epidemiology, University of Extremo Sul Catarinense, Criciuma, Santa Catarina, Brazil., Alexandre MC; Scientific Initiation Scholarship PIC 170, Laboratory of Epidemiology, University of Extremo Sul Catarinense, Criciuma, Santa Catarina, Brazil., Medeiros LR; Postgraduate Program in Medicine, Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil., Bitencourt FS; Medical Residency, São José Hospital, Criciuma, Santa Catarina, Brazil., dos Reis ME; Veterinary Medical, Laboratory of Epidemiology, University of Extremo Sul Catarinense, Criciuma, Santa Catarina, Brazil.
Jazyk: angličtina
Zdroj: ANZ journal of surgery [ANZ J Surg] 2016 Apr; Vol. 86 (4), pp. 255-9. Date of Electronic Publication: 2015 Feb 02.
DOI: 10.1111/ans.12989
Abstrakt: Background: The objective of the study was to verify the accuracy of hyperbilirubinaemia as a marker for acute perforated appendicitis.
Methods: A comprehensive search of the MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, IBECS, BIOSIS, Web of Science, SCOPUS, Congress Abstracts and Grey literature from January 1969 to July 2014. We included cross-sectional and cohort studies, prospective and retrospective, which evaluated hyperbilirubinaemia level in perforated appendicitis and compared them with histological analysis of all appendectomy specimens.
Results: Eleven studies were analysed, which included 5395 patients. Pooled sensitivity was 54.6% (95% confidence interval (CI), 42.8-65.8) and specificity was 70.0% (95% CI, 54.7-81.9%) using STATA. The diagnostic odds ratio was 2.82 (95% CI, 1.38-5.72%). Summary receiver operating characteristic curves were constructed. The area under the curve was 0.65.
Conclusion: This meta-analysis showed that the value of hyperbilirubinaemia alone cannot predict acute perforated appendicitis.
(© 2015 Royal Australasian College of Surgeons.)
Databáze: MEDLINE
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