The value of serum fibrinogen level in the diagnosis of acute appendicitis

Menteş, Öner; Eryılmaz, Mehmet; Harlak, Ali; Öztürk, Erkan; Tufan, Turgut

doi:10.5505/tjtes.2012.58855

Cited by 25 publications

(21 citation statements)

References 20 publications

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“…This rate was found to be 32% by Menteş et al (20), and 7% by Jo et al (21). In the literature, there are few studies giving negative appendectomy rates for AS groups separately.…”

Section: Discussionmentioning

confidence: 94%

Evaluation of the Alvarado scoring system in the management of acute appendicitis

Özsoy¹,

Yenidoğan²

2017

Turk J Surg

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Objective: In this study, we aimed to show the effectiveness of Alvarado score and its components to predict the correct diagnosis of acute appendicitis and to find an optimum cut-off value for Alvarado score. Material and Methods:The patients who underwent surgical operation between January 2011 and January 2012 with the suspicion of acute appendicitis were included in the study. Their demographic and clinical features and histopathological results were retrieved from the medical records. They were divided into three groups according to their Alvarado scores. With the use of "receiver operating characteristic" curve analysis, the optimum cut-off value needed to make a correct diagnosis of acute appendicitis was determined. Results:In all, 156 patients were included into the study. The mean age was 31.41±13.27 years. Histopathologically, acute appendicitis was detected in 125 (80.1%) patients, and negative appendectomy was found in 31 patients (19.8%). Mean Alvarado score was 6.44±1.49. There was a significant correlation between negative appendectomy and low Alvarado score (p<0.001). The main component of Alvarado score that makes the difference was rebound. Fever higher than 37.3°C, rebound, loss of appetite, and existence of shifting pain were statistically differential components (p=0.042, p<0.001, p=0.045, p<0.001, respectively). The rate of correct diagnosis of acute appendicitis was maximum in group 3 (100%) and minimum in group 1 (21.7%). Optimum cut-off value for Alvarado score was 7. Conclusion:Patients with an Alvarado score of over 7 can be taken into surgical operation without the need of imaging methods.

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“…This rate was found to be 32% by Menteş et al (20), and 7% by Jo et al (21). In the literature, there are few studies giving negative appendectomy rates for AS groups separately.…”

Section: Discussionmentioning

confidence: 94%

Evaluation of the Alvarado scoring system in the management of acute appendicitis

Özsoy¹,

Yenidoğan²

2017

Turk J Surg

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“…In our study, the cut-off value for appendicitis was accepted as an Alvarado score of 7, as mentioned in previous publications (8)(9)(10). Patients with an Alvarado score ≥7 were considered to have AA, while AA was ruled out in those with an Alvarado score <7.…”

Section: Discussionmentioning

confidence: 99%

The comparison of the effectiveness of tomography and Alvarado scoring system in patients who underwent surgery with the diagnosis of appendicitis

Öztürk

Yananlı

Atalay

et al. 2016

UCD

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Objective: The aim of this study is to compare the effectiveness of computed tomography and Alvarado scoring system in the diagnosis of acute appendicitis in patients who underwent appendectomy with the preliminary diagnosis of acute appendicitis. Material and Methods:One hundred and one patients who underwent appendectomy with the diagnosis of acute appendicitis between January and December 2011 were included in the study. Alvarado scores were calculated, and abdominal tomography scans were obtained for each patient before surgery. Patients with Alvarado score ≥7 were considered to have appendicitis while patients with a score <7 were considered not to have appendicitis. Patients were classified into two groups based on the presence of appendicitis findings on abdominal tomography. Histopathological examination of the appendices was performed following appendectomy. All patients were classified into groups according to pathology results, Alvarado score and tomography findings. The effectiveness of Alvarado score and tomography were compared using the McNemar test.Results: Sixty patients (59.4%) were male and 41 (40.6%) were female, with a mean age of 32 years (5-85 years). The rate of negative appendectomy was 3.9%. In 78 patients (77.3%) the Alvarado score was ≥7, while 23 patients (22.7%) had Alvarado scores <7. The presence of appendicitis was determined by histopathology in 22 out of 23 patients whose Alvarado score was <7. Tomography indicated appendicitis in 97 patients (95.9%) whereas four patients (4.1%) exhibited no signs of appendicitis by tomography. However, histopathological evaluation indicated the presence of appendicitis in those four patients as well. Conclusion:The study results imply that tomography is a more effective means of diagnosing acute appendicitis as compared to the Alvarado scoring system.

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“…Thus a serial elevated WBC measurement (over 4-8 hours) in suspected cases may increase the specificity, as the WBC count often increases in acute appendicitis 10 (except in case of perforation, in which it may initially fall) [19]. Table 11: Sensitivity and specificity of white blood cell count in diagnosis of acute appendicitis References Sensitivity Specificity Yu et al [20] 62 75 Yang et al [21] 86 32 Xharra et al [22] 85 68 Wu et al [23] 80 71 Agrawal et al [24] 79 55 Mentes et al [25] 72 77 C reactive protein is the prototype acute phase reactant, synthesized by liver, its concentration rises within 8 hours of onset of tissue injury/inflammation, peaks 24 -48 hours and remains elevated as long as continuing tissue inflammation or destruction. CRP was identified in 1930 by Tillett and Francis as a substance in the serum of patients with acute inflammation that reacted with the C polysaccharide of pneumococcus.…”

Section: Discussionmentioning

confidence: 99%

Serum Biomarkers As a Diagnostic Aid in Acute Appendicitis

Jairaj

Narendranath

Ali

et al. 2016

Int J of Biomed & Adv Res

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Background: Acute appendicitis is one of the most common acute intra-abdominal infections seen in surgical departments, which can be treated easily if an accurate diagnosis is made on time. Otherwise, delay in diagnosis and treatment can lead to perforation of the appendix &diffuse peritonitis. Materials and Methods: A prospective study was conducted on 112 patients who were operated for acute appendicitis in department of General surgery, Bowring & Lady Curzon Hospitals, BMCRI, to determine the role and predictive value of the total leucocyte count (TLC), C-reactive protein (CRP) and percentage of neutrophil count in the diagnosis of acute appendicitis. Preoperative TLC, CRP and percentage of neutrophil count were determined and were compared with the results of the histopathology of the removed appendix. Results: Of all the patients studied, 94 had histopathologically positive appendicitis. The TLC was found to be significantly high in 82 patients who proved to have acute appendicitis, whereas CRP was high in 88 patients and neutrophil percentage was raised in 87 patients; 6 patients had a normal CRP level. Thus, TLC had a sensitivity, specificity &positive predictive value of 87.23%, 44.44% and 89.13% respectively. CRP had a sensitivity, specificity & positive predictive value of 93.61%, 77.77% and 95.65% respectively. Percentage of neutrophil count had a sensitivity, specificity & positive predictive value of 92.55%, 38.88%, 88.77% respectively. When used in combination, there was a marked improvement in the sensitivity, specificity and the positive predictive value to98.76%, 86.66% and 97.56% respectively. Conclusion: The inflammatory markers, i.e., TLC, CRP and neutrophil count can be helpful in the diagnosis when measured together as this increases their sensitivity, specificity & positive predictive value significantly.

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The value of serum fibrinogen level in the diagnosis of acute appendicitis

Cited by 25 publications

References 20 publications

Evaluation of the Alvarado scoring system in the management of acute appendicitis

Evaluation of the Alvarado scoring system in the management of acute appendicitis

The comparison of the effectiveness of tomography and Alvarado scoring system in patients who underwent surgery with the diagnosis of appendicitis

Serum Biomarkers As a Diagnostic Aid in Acute Appendicitis

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