Diagnostic value of hyperbilirubinemia and basic laboratory tests in simple and complicated appendicitis

This study aimed to investigate the effectiveness of total serum bilirubin and basic laboratory tests [White Blood Cell (WBC), Neutrophil and Lymphocyte Count, Neutrophil-Lymphocyte Ratio (NLR), Platelet Count, Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet-Lymphocyte Ratio (PLR), C-reactive protein (CRP), Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT)] levels in determining the severity of acute appendicitis (AA) preoperatively in patients operated for AA and reported as AA (Simple-Complicated) as a result of pathology. The medical records of 552 adult patients aged > 18 years who underwent appendectomy for a diagnosis of AA between January 2015 and December 2019 at the General Surgery Clinic of Harran University Faculty of Medicine were retrospectively evaluated. After applying the predefined exclusion criteria, 386 patients were included in the final analysis. Patients were divided into two groups based on the pathology results: Simple or Complicated AA. Demographic characteristics, preoperative total bilirubin levels, and basic laboratory tests were examined. The effectiveness of these tests in differentiating between Simple and Complicated AA was investigated. The mean age of the 386 patients included in this study was 35.33 ± 15.28 years (range, 18–88 years). Based on the pathology results, 296 (76.7%) patients were diagnosed with Simple AA, and 90 (23.3%) patients were diagnosed with Complicated AA. According to the pathology results, the Complicated AA group had a significantly higher mean age (p = 0.001), mean length of hospital stay (p < 0.001), mean NLR (p = 0.008), mean PLR (p = 0.036), mean total bilirubin (p = 0.002), and mean preoperative CRP (p < 0.001) than the Simple AA group. Although total bilirubin and CRP levels showed statistically significant differences between the Simple and Complicated AA groups, no single parameter with sufficient sensitivity and specificity was identified in the preoperative period.