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Original Research 
RMJ. 2020; 45(2): 410-413


Accuracy of hyperbilirubinemia and neutrophil lymphocyte ratio as independent predictors of perforation in acute appendicitis

Mirza Tassawar Hussain, Shamsuddin Syed, Hira Ijaz, Aabid Ali, Erum Khan, Kashif Khan.

Abstract
Objective: To determine the accuracy of hyperbilirubinemia and neutrophil lymphocyte ratio in predicting appendicular perforation.
Methodology: This cross sectional study was conducted in surgical department of Polyclinic Hospital, Islamabad, Pakistan from July 14, 2017 to January 14, 2018. Sample size was 383 patients. A non-probability consecutive sampling technique was used. Hyperbilirubinemia was defined as total bilirubin >1mg/dl and neutrophil lymphocyte ratio (NLR) greater than 5 for predicting appendicular perforation, keeping histopathology as standard for perforation.
Results: Out 383 patients with acute appendicitis, 227(59%) were male and 156(41%) female. Mean age was 25.510.7 years. 35(9.14%) patients had perforated appendix on histopathology. Hyperbilirubinemia had a sensitivity of 54.3%, specificity of 87.1%, NLR >5 had a sensitivity of 74.3%, specificity of 60%.
Conclusions: Hyperbilirubinemia and high NLR should be used in combination with clinical assessment and imaging modalities to improve the diagnostic accuracy for predicting perforation in acute appendicitis.

Key words: Hyperbillirubinemia, neutrophils, lymphocytes, perforated Appendicitis.


 
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How to Cite this Article
Pubmed Style

Hussain MT, Syed S, Ijaz H, Ali A, Khan E, Khan K. Accuracy of hyperbilirubinemia and neutrophil lymphocyte ratio as independent predictors of perforation in acute appendicitis. RMJ. 2020; 45(2): 410-413.


Web Style

Hussain MT, Syed S, Ijaz H, Ali A, Khan E, Khan K. Accuracy of hyperbilirubinemia and neutrophil lymphocyte ratio as independent predictors of perforation in acute appendicitis. http://www.rmj.org.pk/?mno=33628 [Access: May 10, 2020].


AMA (American Medical Association) Style

Hussain MT, Syed S, Ijaz H, Ali A, Khan E, Khan K. Accuracy of hyperbilirubinemia and neutrophil lymphocyte ratio as independent predictors of perforation in acute appendicitis. RMJ. 2020; 45(2): 410-413.



Vancouver/ICMJE Style

Hussain MT, Syed S, Ijaz H, Ali A, Khan E, Khan K. Accuracy of hyperbilirubinemia and neutrophil lymphocyte ratio as independent predictors of perforation in acute appendicitis. RMJ. (2020), [cited May 10, 2020]; 45(2): 410-413.



Harvard Style

Hussain, M. T., Syed, . S., Ijaz, . H., Ali, . A., Khan, . E. & Khan, . K. (2020) Accuracy of hyperbilirubinemia and neutrophil lymphocyte ratio as independent predictors of perforation in acute appendicitis. RMJ, 45 (2), 410-413.



Turabian Style

Hussain, Mirza Tassawar, Shamsuddin Syed, Hira Ijaz, Aabid Ali, Erum Khan, and Kashif Khan. 2020. Accuracy of hyperbilirubinemia and neutrophil lymphocyte ratio as independent predictors of perforation in acute appendicitis. Rawal Medical Journal, 45 (2), 410-413.



Chicago Style

Hussain, Mirza Tassawar, Shamsuddin Syed, Hira Ijaz, Aabid Ali, Erum Khan, and Kashif Khan. "Accuracy of hyperbilirubinemia and neutrophil lymphocyte ratio as independent predictors of perforation in acute appendicitis." Rawal Medical Journal 45 (2020), 410-413.



MLA (The Modern Language Association) Style

Hussain, Mirza Tassawar, Shamsuddin Syed, Hira Ijaz, Aabid Ali, Erum Khan, and Kashif Khan. "Accuracy of hyperbilirubinemia and neutrophil lymphocyte ratio as independent predictors of perforation in acute appendicitis." Rawal Medical Journal 45.2 (2020), 410-413. Print.



APA (American Psychological Association) Style

Hussain, M. T., Syed, . S., Ijaz, . H., Ali, . A., Khan, . E. & Khan, . K. (2020) Accuracy of hyperbilirubinemia and neutrophil lymphocyte ratio as independent predictors of perforation in acute appendicitis. Rawal Medical Journal, 45 (2), 410-413.








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