| Abstrakt: |
BACKGROUND In order to distinguish individuals with a difficult perforated appendicitis from those with an acute appendicitis that is not too complicated, there is a growing need for quick and safe markers. That is why the current study was conducted to see if a higher-than-normal bilirubin level may be used as a predictor of an appendicular perforation diagnosis. METHODS Between October 2021 and October 2022, 100 patients who had been hospitalised at Government Vellore Medical College and Hospital for acute appendicitis and were undergoing emergency appendectomy participated in a prospective, non-randomized observational study. A Microsoft Excel spreadsheet was used to total and analyse the data that was gathered. The odds ratio, sensitivity, specificity, positive predictive value, and negative predictive value were computed using a 2 x 2 table. RESULTS Of the 100 patients, 36% had an appendicular perforation and 64% had a clinical diagnosis of acute appendicitis. Out of the 36 patients who received an appendix perforation diagnosis, 24 had high bilirubin levels and 12 had normal bilirubin levels. The age range of 21 to 30 years old was the one where appendicular perforations were most common. Compared to just 16.7% of individuals with values <=1, appendicular perforation was seen in 85.7% of patients with total bilirubin >1 mg/dl. There was a statistically significant difference (p<0.001). Total bilirubin had 83.3% and 85.7%, respectively, of sensitivity and specificity in predicting the diagnosis of acute appendicitis and appendicular perforation. Total bilirubin had a 93.7% positive predictive value for both the diagnosis of appendicitis and appendicular perforation. 66.7% was the negative predictive value. 86.2% of patients with direct bilirubin >0.3 mg/dl developed appendicular perforation, whereas only 15.5% of patients with levels between 0.1 and 0.3 mg/dl experienced this condition. CONCLUSION In addition to or instead of other biochemical and radiographic markers, serum bilirubin has the specificity and sensitivity to predict appendicular perforation. [ABSTRACT FROM AUTHOR] |
