Diagnostic Accuracy Of Hyperbilirubinemia In Acute Appendicitis

Abstract

Objective: To determine the diagnostic accuracy of serum Bilirubin in cases of acute appendicitis keeping the histopathological findings as Gold standard. Study Design: Cross sectional validation study. Place and Duration of the Study: Surgical Unit, Sheikh Khalifa Bin Zayed Al-Nayhan Hospital (Combined Military Hospital), Rawalakot, Azad Kashmir, from Jan 2022 to June 2022. Methodology: A total of 380 patients aged between 18 to 65 years, who matched the inclusion and exclusion criteria suspected of acute appendicitis were included. Serum Bilirubin level was noted. Appendectomy was done. Specimen of appendix was sent for histopathology for confirmation of the diagnosis. Results: In our study, mean age of the patients was 34.015 with a standard deviation of 13.32. 65% (n=247) of the patients were males and 35% (n=133) were females. Frequency of acute appendicitis on histopathology was 82.89% (n=315) while 17.1% (n=65) had no findings of the disease. Validity of serum Bilirubin in diagnosing appendicitis using histopathology showed 57.36% (n=218) were true positive, 2.1% (n=8) were false positive, 15% (n=57) were true negative and 25.52 %( n=97) were false negative. Specificity, sensitivity, negative predictive value, positive predictive value, accuracy rate, positive likelihood ratio and negative likelihood ratio were 87.69%, 69.20%, 37.01%, 96.46%, 72.36%, 5.62 and 0.35 respectively. Conclusion: Serum Bilirubin is a useful marker for diagnosing the acute appendicitis and can be used as a good alternative diagnostic modality in suspected cases of acute appendicitis.