Hyperbilirubinemia as a predictor for appendiceal perforation: a systematic review.

Abstract

BACKGROUND AND AIMS:

Delayed or wrong diagnosis in patients with appendicitis can result in perforation and consequently increased morbidity and mortality. Serum bilirubin may be a useful marker for appendiceal perforation. The purpose of this systematic review was to evaluate studies investigating elevated serum bilirubin as a predictor for appendiceal perforation.

MATERIAL AND METHODS:

Medline, Embase, and Cochrane databases were searched for studies evaluating elevated bilirubin in the diagnosis of perforated appendicitis. Study selection criteria included English language papers evaluating serum bilirubin as a marker of appendiceal perforation in humans. A total of 189 abstracts were screened for eligibility, of which five clinical studies were included in this study.

RESULTS:

Bilirubin was significantly higher in patients with appendiceal perforation compared with patients with appendicitis without perforation. Elevated serum bilirubin had a sensitivity ranging from 0.38 to 0.77 and a specificity ranging from 0.70 to 0.87 in predicting appendiceal perforation.

CONCLUSIONS:

Elevated serum bilirubin for determining the risk of perforation in appendicitis has low sensitivity but higher specificity. This measure can therefore be used as a supplement in the diagnostic process.

• Authors: J Burcharth, H C Pommergaard, J Rosenberg, I Gögenur
• Journal: Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society (Scand J Surg) Vol. 102 Issue 2 Pg. 55-60 ( 2013) ISSN: 1799-7267 [Electronic] England
• PMID: 23820677 (Publication Type: Journal Article, Review, Systematic Review)

Chemical References

• Biomarkers
• Bilirubin

Topics

• Appendicitis (blood, complications, diagnosis)
• Bilirubin (blood)
• Biomarkers (blood)
• Humans
• Hyperbilirubinemia (blood, etiology)
• Sensitivity and Specificity