Bilirubin als diagnostischer Marker der akuten perforierten Appendizitis

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dc.contributor.advisor Kirschniak, Andreas (PD Dr.) Hein, Dirk Phillip 2017-05-30T07:08:28Z 2017-05-30T07:08:28Z 2017-05-30
dc.identifier.other 489098487 de_DE
dc.identifier.uri de_DE
dc.description.abstract BACKGROUND: Hyperbilirubinaemia is reported to be a positive predictor in diagnosing appendicitis and especially appendiceal perforation. We, therefore, analysed the diagnostic accuracy of serum bilirubin in anticipating appendicitis and its severity. METHODS: All consecutive patients undergoing appendectomy for suspected appendicitis from May 2009 to August 2011 were analysed. Patients were classified based on final histopathological findings into the groups: no appendiceal inflammation, non-perforated appendicitis and perforated appendicitis. Primary outcome was the diagnostic accuracy of serum bilirubin levels in discriminating between no appendiceal inflammation and any appendicitis (perforated and non-perforated appendicitis) and non-perforated and perforated appendicitis. RESULTS: Of 493 analysed patients, 125 (25%) had no appendiceal inflammation, 312 (64%) had non-perforated appendicitis and 56 (11%) had perforated appendicitis. The proportion of patients with bilirubin elevation (>1.1 mg/dL) was different between those with no appendiceal inflammation (14%) and any appendicitis (36%) (p<0.0001), and between non-perforated appendicitis and perforated appendicitis 48% (p=0.04). However, the positive and negative likelihood ratios (LRs) for an elevated bilirubin were poor at discriminating the groups: no appendiceal inflammation versus any appendicitis (LR+ 2.62 (95% CI 1.65 to 4.16) and LR- 0.75 (95% CI 0.67 to 0.83)) and non-perforated appendicitis versus perforated appendicitis (LR+ estimate 1.74 (95% CI 1.28 to 2.38) and LR- 0.72 (95% CI 0.55 to 0.93)). CONCLUSIONS: Hyperbilirubinaemia is present in acute appendicitis but has a low diagnostic accuracy in discriminating between any appendicitis versus no appendiceal inflammation and perforated versus non-perforated appendicitis and is, therefore, of limited value in clinical routine. en
dc.language.iso de de_DE
dc.publisher Universität Tübingen de_DE
dc.rights ubt-podok de_DE
dc.rights.uri de_DE
dc.rights.uri en
dc.subject.classification Blinddarmentzündung , Hyperbilirubinämie , Akutes Abdomen de_DE
dc.subject.ddc 610 de_DE
dc.title Bilirubin als diagnostischer Marker der akuten perforierten Appendizitis de_DE
dc.type Dissertation de_DE
dcterms.dateAccepted 2017-03-30
utue.publikation.fachbereich Medizin de_DE
utue.publikation.fakultaet 4 Medizinische Fakultät de_DE
utue.publikation.source Emerg Med J. 2015 Sep;32(9):698-702. doi: 10.1136/emermed-2013-203349. Epub 2014 Dec 4. de_DE


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