Accuracy of hyperbilirubinemia and neutrophil lymphocyte ratio as independent predictors of perforation in acute appendicitis | [Rawal Medical Journal • 2020]

Author(s):

1. Mirza Tassawar Hussain: Department of Surgery, Federal Government Polyclinic Hospital,Islamabad,Pakistan

2. Shamsuddin Syed: Department of Surgery, Federal Government Polyclinic Hospital,Islamabad,Pakistan

3. Hira Ijaz: Department of Surgery, Federal Government Polyclinic Hospital,Islamabad,Pakistan

4. Aabid Ali: Department of Surgery, Federal Government Polyclinic Hospital,Islamabad,Pakistan

5. Erum Khan: Department of Surgery, Federal Government Polyclinic Hospital,Islamabad,Pakistan

6. Kashif Khan: Department of Surgery, Federal Government Polyclinic Hospital,Islamabad,Pakistan

Abstract:

Objective: To determine the accuracy of hyperbilirubinemia and neutrophil lymphocyte ratio in predicting appendicular perforation. Methodology: This cross sectional study was conducted in surgical department of Polyclinic Hospital, Islamabad, Pakistan from July 14, 2017 to January 14, 2018. Sample size was 383 patients. A non-probability consecutive sampling technique was used. Hyperbilirubinemia was defined as total bilirubin >1mg/dl and neutrophil lymphocyte ratio (NLR) greater than 5 for predicting appendicular perforation, keeping histopathology as standard for perforation. Results: Out 383 patients with acute appendicitis,227(59%) were male and 156(41%) female. Mean age was 25.5±10.7 years. 35(9.14%) patients had perforated appendix on histopathology. Hyperbilirubinemia had a sensitivity of 54.3%, specificity of 87.1%, NLR >5 had a sensitivity of 74.3%, specificity of 60%. Conclusions: Hyperbilirubinemia and high NLR should be used in combination with clinical assessment and imaging modalities to improve the diagnostic accuracy for predicting perforation in acute appendicitis.

Page(s): 410-413

DOI: DOI not available

Published: Journal: Rawal Medical Journal, Volume: 45, Issue: 2, Year: 2020

Keywords:

Lymphocytes , Hyperbillirubinemia , Perforated , Neutrophils , Appendicitis

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