Serum Bilirubin and CReactive Protein as predictor of perforation in Acute Appendicitis A prospective cohort study

Dr. Shahab Faria Shahabuddin; Dr. Shehtaj Khan; Dr. Rafiul Imad Finan; Prof. M. Amanullah Khan

Volume : V, Issue : XI, November - 2016

Serum Bilirubin and CReactive Protein as predictor of perforation in Acute Appendicitis A prospective cohort study

Dr. Shahab Faria Shahabuddin, Dr. Shehtaj Khan, Dr. Rafiul Imad Finan, Prof. M. Amanullah Khan

Abstract :

Introduction– Acute appendicitis is a common surgical emergency, further complicated by gangrene, perforation and diffuse peritonitis. An early diagnosis and treatment of perforated appendix can decrease cost as well as morbidity associated with the disease. Total Serum Bilirubin (TSB) and C–reactive protein (CRP) can be potential markers to predict perforation in patients with acute appendicitis. Method– TSB and CRP were measured in patients with acute appendicitis. Patients were divided into two groups– group 1 (without appendicular perforation) and group 2 (with appendicular perforation) on the basis of operative findings. Sensitivity, Specificity, Positive predictive value (PPV) and Negative predictive value (NPV) were calculated for both parameters. Results– The sensitivity, specificity, PPV and NPV of raised TSB in Group 2 were 86.66%, 65.71%, 72.22% and 92% respectively. The sensitivity, specificity, PPV and NPV for CRP was 80.0%, 54.28%, 38.7%and 84% respectively. TSB was found to be a better marker for diagnosing perforated appendix than CRP. Conclusion– Both TSB and CRP are useful markers for early diagnosis of perforated appendix, with TSB being better than CRP. But, the present study has a limitation with respect to sample size