| BackgroundAcute appendicitis (AA) is the most common acute condition ofabdomen and Alvarado score (AS) is the most popular scoring system usedin the diagnosis of AA. Recent studies have shown red cell distributionwidth, hyperbilirubinemia, hyponatremia and serum fibrinogen to beassociated with gangrenous or perforated changes of appendix. Theretrospective study aim to investigate the relationship between Alvaradoscore, red cell distribution width (RDW), total bilirubin (TB), serumnatrium (Na), serum fibrinogen (Fg) and histologic results of AA.MethodsWe identified179patients (92male,87female, mean age,44.1y) withhistologically proved AA who underwent open or laparoscopicappendectomy between December2011and December2013in thegastrointestinal surgical department of The First Affiliated Hospital OfChongqing Medical University. A retrospective multiple chart review of the medical records including AS, RDW, TB, Na, Fg and histologic results wasconducted.ResultsPatients with acute simple appendicitis had a mean Alvarado score of6.7(±1.7SD; range,4-10), which was significantly lower than otherpatients’(P <0.05). The mean TB and Fg of patients with appendicealgangrene or perforation was significantly higher than those with anonperforated or nongangrenous appendicitis (P <0.05). ROC analysis forTB showed the optimal sum of sensitivity (75.7%) and specificity (64.2%)at a cut-off level of greater than20.25μmol/L. ROC analysis for Fg showedthe optimal sum of sensitivity (71.4%) and specificity (63.3%) at a cut-offlevel of greater than4.07g/L. In patients older than60years, the sensitivity,specificity and cut-off value of TB was86.4%,71.4%and21.80μmol/L.ConclusionLow Alvarado score means more likely nonperforated or nongangrenousappendicitis. TB and Fg are statistically significant markers for gangrenousor perforated changes in patients with AA. RDW, Na can’t be associatedwith histologic results of AA. TB might indicate the gangrenous orperforated changes in patients older than60years. |
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