2016, Number 5
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Rev Med Inst Mex Seguro Soc 2016; 54 (5)
Hyperbilirrubinemia as a predictive factor of perforated appendicitis
Alanis-Rivera B, Zuñiga-Vazquez LA, Silva-Escamilla MC
Language: Spanish
References: 38
Page: 552-561
PDF size: 322.44 Kb.
ABSTRACT
Background: Recent studies considered hyperbilirubinemia as a marker
to identify the presence of perforated appendix. The aim of the study is to
verify that the presence of hyperbilirubinemia is a useful marker to identify
the presence of perforated appendix before surgery, and thereby,
provide early treatment to avoid progression of the disease and its complications.
Methods: This is a retrospective study, which identified 225 patients,
who met the inclusion and exclusion criteria, from January 2012 to October
2014 at the IMSS General Hospital 29, taking into account laboratory
results and postoperative, performing a univariate, bivariate and multivariate
analysis.
Results: 56.9% showed bilirubin ‹ 1, from which 16.4% presented perforation,
while 43.1% showed bilirubin › 1, 62.88% presented perforated
appendicitis. Hyperbilirubinemia increases 17 times the risk of perforated
appendix (RMP: 17.63; IC 95%: 6.882-45.207; p ‹ 0.001) which is statistically
significant.
Conclusions: Considering the limitations of this study, it can be inferred
that hyperbilirubinemia is present in a great number of patients with perforated
appendicitis, so it could be considered a relevant laboratory test
to include within the protocol of appendicitis, which in turn, may determine
a better planning for the surgical approach.
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