Severity of Acute Appendicitis is Predicted by Hyperbilirubinemia: A Clinical Clue

Abstract

Background: One of the most frequent abdominal emergencies requiring emergency surgery is acute appendicitis, and appendectomy is the most common emergency procedure performed globally. There is an urgent need for a predictor of the severity of acute appendicitis since delayed identification and treatment of severe appendicitis are linked to higher risks of perforation and postoperative morbidity, mortality, and prolong hospital stay. Objectives: The aim of this study was to assess how the severity of acute appendicitis is predicted by hyperbilirubinemia. Methods: This descriptive cross-section study was carried out in the Department of Surgery at Combined Military Hospital (CMH), Cumilla, during March 2021 to Feb 2023. A total of 80 patients purposing were included in this study. Among them 30 were diagnosed as complicated appendicitis and rest 50 were simple appendicitis patients. Patients diagnosed with complicated appendicitis and simple appendicitis irrespective of age and sex were included in the study. Patients who were not given consent to participate in the study were excluded from the study. After taking consent and matching eligibility criteria, data were collected from patients on variables of interest using the predesigned structured questionnaire by interview, observation, clinical examination and hematological investigation of the patients. Statistical analyses of the results were obtained by using window based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-26), where required. Results: In complicated appendicitis 40% were male and 60% were female. In simple appendicitis 40% were male and 60% were female. The mean T-Bil in complicated appendicitis was 1.187mg/dL and 1.00 mg/dL in simple appendicitis. About 46.0% patients had hyperbilirubinemia in complicated appendicitis and 32.5% in simple appendicitis. Here, 58.0% had fever >37.30C in complicated appendicitis and 33.5% in simple appendicitis. About 69.7% had positive ..........