High bilirubin levels are a risk factor for severe acute appendicitis

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Abstract Objective The present research aimed to examine the clinical importance of preoperative hyperbilirubinemia in Sharkia, Egypt, patients and determine whether it has any practical application for predicting the magnitude of acute appendicitis. Methods Between January 2020 and December 2023, 636 appendicitis patients who received an appendectomy were evaluated. Using multivariate analysis, we looked at predictive data for complex (perforated or gangrenous) appendicitis, including demographics, gender, white blood cell count, degree C-reactive protein (CRP) elevation, high-temperature peritoneal signs indicators, and bilirubin level. Results Raised bilirubin level is highly appreciated in patients with ith perforated or gangrenous appendix. The total bilirubin (>1.1 mg/dL), elevated CRP (>0.5 mg/dL), severe peritonitis that started at the site of the appendix (right iliac fossa), The widespread peritonitis when ruptured or gangrenous occurred with high temperature, first temperature (>37.3°C) when still congested appendicitis and elevated above > 48 - 40 when general peritonitis established. The multivariate analysis presented older age > 64 years, elevated bilirubin, raised CPR, and high temperature (odds ratios of 3.36, 1.75, 7.61, and 2.43, respectively) as predictive risk factors for severity. The multivariate analysis presented older age > 64 years, elevated bilirubin, raised CPR, and high temperature (odds ratios of 1.99, 5.90, and 2.72, respectively) as a predictive risk factors for severity between age 65 years. Conclusions High temperature, elevated CRP, and hyper Bilirubin were helpful indicators of the degree of seriousness of acute appendicitis, with excessive Bilirubin being particularly helpful in individuals under 65.

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