2020, Number 3
Next >>
Revista Cubana de Cirugía 2020; 59 (3)
Levels of C-reactive protein, bilirubin and leucocytes as predictors of anotomopathological appendicular evolution
Bengoechea TA, Borreiros RE, Pérez GD, Mayo OMÁ, Pacheco GJM
Language: Spanish
References: 14
Page: 1-12
PDF size: 576.59 Kb.
ABSTRACT
Introduction:
Acute appendicitis is the most frequent surgical emergency in any hospital worldwide. Although most of the time it is a trivial intraabdominal process, sometimes it presents an unneglectable morbidity. This morbidity and the subsequent mortality are associated, in most cases, with advanced stages of an appendicular disease.
Objective:
To predict, using the value corresponding to bilirubin, C-reactive protein and leukocyte count, the state of acute appendicular process presented by patients.
Methods:
A descriptive observational study was carried out, including patients operated on for suspected acute appendicitis during a period of three years (2017-2019) and who met the inclusion criteria. The values for leukocyte count, C-reactive protein, and bilirubin were analyzed as laboratory data.
Results:
An increase in the values of C-reactive protein and bilirubin levels was observed in advanced appendicular cases, as other authors have shown in the medical literature. Likewise, these two values have turned out to be a risk factor for presenting severe forms. However, the level of leukocytes has not been shown to be related to the severity of the process.
Conclusions:
We consider the use of the biomarkers studied as relevant to predict appendicular severity in view of improving care of these patients and reducing complications derived from therapeutic delay.
REFERENCES
Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet. 2015;386(10000):1278.
Ditillo MF, Dziura JD, Rabinovici R. Is it safe to delay appendectomy in adults with acute appendicitis? Ann Surg. 2006 Nov;244(5):656-60.
United Kingdom National Surgical Research Collaborative, Bhangu A. Safety of short, in-hospital delays before surgery for acute appendicitis: multicentre cohort study, systematic review, and meta-analysis. Ann Surg. 2014;259(5):894.
Teixeira PG, Sivrikoz E, Inaba K, Talving P, Lam L, Demetriades D, et al. Appendectomy timing: waiting until the next morning increases the risk of surgical site infections. Ann Surg. 2012 Sep;256(3):538-43.
Andersson REB. Meta-analysis of the clinical and laboratory diagnosis of appendicitis. Br J Surg. 2004;91(1):28-37.
Xharra S, Gashi-Luci L, Xharra K, Veselaj F, Bicaj B, Sada F, et al. Correlation of serum C-reactive protein, white blood count and neutrophil percentage with histopathology findings in acute appendicitis. World J Emerg Surg. 2012;7(1):27-32.
Al-Abed YA, Alobaid N, Myint F. Diagnostic markers in acute appendicitis. Am J Surg. 2014;209(6):1043-1047.
Yang HR, Wang YC, Chung PK, Chen WK, Jeng LB, Chen RJ, et al. Laboratory tests in patients with acute appendicitis. ANZ J Surg. 2006;76(1-2):71-74.
Grönroos JM, Grönroos P. Leucocyte count and C-reactive protein in the diagnosis of acute appendicitis. Br J Surg. 1999;86(4):501-504.
Amalesh T, Shankar M, Shankar R. CRP in acute appendicitis: is it a necessary investigation? Int J Surg. 2004;2(2):88-9.
Sand M, Bechara FG, Holland-Letz T, Sand D, Mehnert G, Mann B, et al. Diagnostic value of hyperbilirubinemia as a predictive factor for appendiceal perforation in acute appendicitis. Am J Surg. 2009;198(2):193-8.
Estrada JJ, Petrosyan M, Barnhart J, Tao M, Sohn H, Towfigh S, et al. Hyperbilirubinemia in appendicitis: a new predictor of perforation. J Gastrointest Surg. 2007;11(6):714-18.
Burcharth J, Pommergaard HC, Rosenberg J, Gögenur I. Hyperbilirubinemia as a predictor for appendiceal perforation: a systematic review. Scand J Surg. 2013;102(2):55-60.
Wu H, Huang C, Chang Y, Chou C, Ling C. Use of changes overtime in serum inflammatory parameters in patients with equivocal appendicitis. Surg. 2006;139(6):789-96.