The value of serum fibrinogen level in the diagnosis of acute appendicitis

BACKGROUND
The aim of this study was to investigate the importance of serum fibrinogen level in the diagnosis of acute appendicitis.
METHODS
This study was performed on 201 patients who admitted to our clinic. Symptoms, signs, duration of symptoms, and laboratory indicators of appendicitis were recorded, in keeping with the Alvarado score for acute appendicitis. The ultimate diagnosis was based on histopathological results. Serum fibrinogen levels were detected before surgery. The sensitivity, specificity, and predictive values of single test and test combinations were calculated at different cut-off levels.
RESULTS
During the study period, 201 patients underwent surgery for suspected acute appendicitis. Appendicitis was confirmed in 179 (89%) patients. The mean age was 24.8±7.7 (range, 20-57) years, and 154 (76.6%) patients were male and 47 (23.4%) female. The best diagnostic cut-off point for fibrinogen was found at 245.5 mg/dl, for white blood cells (WBC) at 11,900x109/L and for Alvarado score at 7.
CONCLUSION
The use of fibrinogen blood level may be a new diagnostic acute-phase reactant in the diagnosis of acute appendicitis. The formulation of a triple test is recommended as criteria in deciding emergency surgery or observation.

Akut apandisit tanýsýnda serum fibrinojen düzeyinin deðeri

AMAÇ
Bu çalýþmada akut apandisit tanýsýnda serum fibrinojen düzeyinin önemi araþtýrýldý.
GEREÇ VE YÖNTEM
Kliniðimize baþvuran 201 hasta çalýþmaya alýndý. Hastalarýn semptomlarý, semptom süreleri, muayene bulgularý, laboratuvar bulgularý ve akut apandisit için Alvarado skorlarý kaydedildi. Kesin taný histopatolojik inceleme ile konuldu. Ameliyat öncesi kan fibrinojen deðerine bakýldý. Tek bir testin ve test kombinasyonlarýnýn duyarlýlýk, özgüllük ve öngörü deðeri farklý seviyelerinde hesaplandý.
BULGULAR
Çalýþma süresinde 201 hasta akut apandisit ön tanýsý ile ameliyat edildi. Histopatolojik inceleme sonrasý 179 (%89) hasta akut apandisit tanýsý aldý. Hastalarýn yaþ ortalamasý 24,8±7,7 (daðýlým 20-57) yýldý, 154 (%76.6) hasta erkek, 47 (23.4%) hasta kadýndý. Akut apandisit tanýsý için kesim deðeri fibrinojen için 245,5 mg/dl, beyaz küre sayýmý için 11.900x109/L ve Alvarado skoru için 7 olarak bulundu.
SONUÇ
Akut apandisit tanýsýnda fibrinojenin serum deðeri yeni bir akut faz reaktamý olarak kullanýlabilir. Üçlü test formülünün kullanýlmasý gözlem veya acil cerrahi kararýný vermede yardýmcý olabileceði düþünülmektedir.