ASSESSMENT OF ACCURACY OF HYPERBILIRUBINEIA IN EARLY DIAGNOSIS OF ACUTE APENDICITIS IN OUR POPULATION

Abstract

Objective: To determine the assessment of accuracy of hyperbilirubinemia in the diagnosis of acute appendicitis keeping histopathology as gold standard.

Study Design: Cross-sectional validation study.

Place and Duration of Study: Combined Military Hospital Rawalpindi, form Jan 2014 to Jul 2014.

Methodology: After approval of hospital ethical committee, total number of 180 consecutive patients presenting in emergency department with suspicion of acute appendicitis were admitted in hospital. After fulfilling the inclusion and exclusion criteria and taking detailed history and examination, investigations were ordered and appendectomy was done within 24 hours and sent for histopathology examination by the consultant at armed forces institute of pathology.

Results: In our study, mean age was 35.45 ± 7.43 years, 97 (53.89%) were male and 83 (46.11%) were females, frequency of acute appendicitis on histopathology (gold standard) was recorded in 149 (82.78%). Assessment of accuracy of hyperbilirubinemia in diagnosis of acute appendicitis using histopathology as gold standard shows 119 (66.11%) were true positive, 11 (6.11%) were false positive, 20 (11.11%) were true negative and 30 (16.67%) were false negative. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate was computed as 79.87%, 64.52%, 91.54%, 40% and 77.22% respectively.

Conclusion: The assessment of accuracy of hyperbilirubinemia in diagnosis of acute appendicitis keeping histopathology as gold standard was found a useful marker and may be used as an adjuvant diagnostic technique for acute appendicitis.