Clinical trial NCT06956638: Bilirubin Levels to Diagnose Appendicitis and Predict Appendiceal Perforation
Official title: Predictors of Appendiceal Perforation and the Role of Total Bilirubin at Presentation: A Single Center Prospective Cross-sectional Study in Nepal
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Acute Appendicitis
Appendicitis Perforated
Keywords: Single-center
prospective
cross-sectional
Lead sponsor: Nepalese Army Institute of Health Sciences
Sponsor class: OTHER
First posted: 2025-05-04
Enrollment: 98
Sex: ALL
Minimum age (years): 5
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients presenting with acute appendicitis at Shree Birendra Hospital, Chhauni, Kathmandu

Brief summary: The goal of this study is to learn if serum bilirubin levels can aid in the diagnosis of acute appendicitis and predict appendiceal perforation

Detailed description: The study aims to assess hyperbilirubinemia: serum direct, indirect and total bilirubin to enhance the diagnostic accuracy of acute appendicitis. Also it aims to analyze different patient variables such as age, gender, duration of symptoms, leukocyte and neutrophil count, Alvarado score, presence of fever, nausea \& vomiting, peritonitis alongside serum total bilirubin level in patients with appendicitis and assess which variables can be taken as independent factors to predict appendiceal perforation.

Eligibility criteria: Inclusion Criteria:

* Patients of age group above 5 years with acute appendicitis undergoing appendectomy with written informed consent.

Exclusion Criteria:

* Patients with appendicular lump.
* Patients with acute and chronic liver diseases like acute hepatitis, hemolytic disease, Gilbert's syndrome, Dubin-Johnson syndrome, alcoholic liver disease.
* Acquired or Congenital Biliary Disease.
* History of Hepatotoxic drugs.

Primary outcomes:
measure: Perforated appendix
timeFrame: Presentation to hospital till perioperative period
Secondary outcomes:
Other outcomes:
Locations:
city: Kathmandu
country: Nepal
facility: Shree Birendra Hospital
state: Bagmati
Study officials:
affiliation: Nepalese Army Institute of Health Sciences
name: Bhairav Kumar Hamal, MS, Fellow - Urosurgery
role: STUDY_CHAIR
References:
citation: Sirikurnpiboon S, Amornpornchareon S. Factors Associated with Perforated Appendicitis in Elderly Patients in a Tertiary Care Hospital. Surg Res Pract. 2015;2015:847681. doi: 10.1155/2015/847681. Epub 2015 Aug 24.
citation: Potey K, Kandi A, Jadhav S, Gowda V. Study of outcomes of perforated appendicitis in adults: a prospective cohort study. Ann Med Surg (Lond). 2023 Mar 16;85(4):694-700. doi: 10.1097/MS9.0000000000000277. eCollection 2023 Apr.
citation: Chaudhary P, Kumar A, Saxena N, Biswal UC. Hyperbilirubinemia as a predictor of gangrenous/perforated appendicitis: a prospective study. Ann Gastroenterol. 2013;26(4):325-331.
citation: Sand M, Bechara FG, Holland-Letz T, Sand D, Mehnert G, Mann B. Diagnostic value of hyperbilirubinemia as a predictive factor for appendiceal perforation in acute appendicitis. Am J Surg. 2009 Aug;198(2):193-8. doi: 10.1016/j.amjsurg.2008.08.026. Epub 2009 Mar 23.