Efficacy of bilirubin values in diagnosing acute appendicitis in patients with normal white blood cell count and predicting complicated appendicitis

BACKGROUND: Laboratory parameters have important diagnostic value in the evaluation of acute appendicitis. This study aimed to evaluate the efficacy of bilirubin values in predicting acute and complicated appendicitis in patients with leukocyte values in the normal reference range.
METHODS: This study included 200 patients aged 18 and over who underwent appendectomy with leukocyte values within the normal reference range. The demographic characteristics, total and direct bilirubin and C-reactive protein values of the patients were examined. According to the pathology results, the patients were divided into two groups as a normal appendix and acute appendicitis. Acute appendicitis was further classified as simple and complicated.
RESULTS: Of the 200 patients included in this study, 110 (55%) were female and 90 (45%) were male, and the mean age was 37±16 years. The pathology results were reported as normal in 45 (22.5%) and acute appendicitis in the remainder of the sample. Of those diagnosed with acute appendicitis, 141 (91%) had simple appendicitis and 14 (9%) had complicated appendicitis. When the normal appendix and acute appendicitis groups were compared, the total and direct bilirubin levels were higher in the patients diagnosed with acute appendicitis. According to the receiver operator characteristic curve analysis, the area under the curve values of total bilirubin and direct bilirubin for the prediction of acute appendicitis were 0.597 and 0.625, respectively.
CONCLUSION: In patients with normal leukocyte values, high bilirubin levels may be useful in predicting the diagnosis of acute appendicitis.

Beyaz küresi normal hastalarda akut apandisit tanýsý koymada ve komplike apandisiti ön görmede bilirubin deðerlerinin etkinliði

AMAÇ: Akut apandisitin deðerlendirilmesinde laboratuvar parametreleri önemli tanýsal deðere sahiptir. Bu çalýþmanýn amacý, lökosit deðerleri normal referans aralýðýnda olan hastalarda bilirubin deðerlerinin akut ve komplike apandisiti ön görmedeki etkinliðini deðerlendirmektir.
GEREÇ VE YÖNTEM: Lökosit deðeri normal referans aralýðýnda olan ve apendektomi yapýlan 18 yaþ ve üzeri 200 hasta çalýþmaya dahil edildi. Hastalarýn demografik özellikleri total ve direkt bilirubin ve C-reaktif protein deðerleri incelendi. Hastalar patoloji sonucuna göre normal apendiks ve akut apandisit olarak ikiye ayrýldý. Akut apandisitlerde, basit apandisit ve komplike apandisit olarak sýnýflandýrýldý.
BULGULAR: Çalýþmaya dahil edilen 200 hastanýn 110’u (%55) kadýn, 90’ý (%45) erkekti ve yaþ ortanca deðeri 37±16 yýl idi. Patoloji sonuçlarý 45’inde (%22.5) normal apendiks, geri kalanýnda ise akut apandisit olarak raporlandý. Akut apandisit tanýsý alanlarýn 141’inde (%91) basit apandisit ve 14’ünde (%9) komplike apandisit saptandý. Normal apendiks ve akut apandisit karþýlaþtýrýldýðýnda total ve direkt bilirubin seviyeleri akut apandisit tanýsý alanlarda daha yüksek bulundu. Akut apandisiti ön görmede iþlem karakteristik eðrisi analizinde total bilirubin ve direkt bilirubin’in eðri altýnda kalan alaný sýrasýyla 0.597 ve 0.625 idi.
TARTIÞMA: Lökosit deðerinin normal olduðu hastalarda yüksek bilirubin deðerleri akut apandisit tanýsýný ön görmede faydalý olabileceði sonucuna varýldý.