The predictive value of total bilirubin for acute appendicitis in retrospect

Abstract Objective The present study aimed to examine the clinical importance of preoperative total bilirubinemia in patients with acute appendicitis and to determine whether it has any practical application for predicting severe appendicitis. Methods A retrospective analysis of appendicectomies was performed at one hospital ( 636 cases of acute appendicitis presenting to the emergency department between December 2019 and January 2023). Using multivariate analysis, we examined predictive data for complex (perforated or gangrenous) appendicitis, including demographics, sex, white blood cell count, degree of C-reactive protein (CRP) elevation, high-temperature peritoneal signs and indicators, and total bilirubin levels. Results Those with total bilirubin (> 1.1 mg/dL), high C-reactive protein (CRP) levels (> 0.5 mg/dL), positive peritoneal irritated symptoms, and temperature (> 37.3 C) had considerably higher rates of acute appendicitis. Age (> 64 years), hyperbilirubinemia, high CRP levels, and fever (odds ratios of 3.36, 1.75, 7.61, and 2.43, respectively) were identified by multivariate analysis as associated risks for complex appendicitis. This is particularly true for those under 65 years of age. Conclusions High temperature, elevated CRP level, and high total bilirubin level were good predictors of acute appendicitis, especially in patients younger than 65 years; however, total bilirubin level was a more precise indicator.