title: Diagnostic value of serum fibrinogen as a predictive factor for complicated appendicitis (perforated). A cross-sectional study.
abstract: BACKGROUND
  Acute appendicitis (AA) has a prevalence of 8% in the general population with a rate of complicated (perforated) appendicitis (CA) up to 40%. Serum fibrinogen may serve as an indicator for CA.
  
  
  METHODS
  115 patients were included from January 2012 to December 2012 using a positive pathology report for AA as a gold standard diagnostic method. We divided the patients into two groups accordingly to the pathology report: Complicated Appendicitis and Uncomplicated Appendicitis (UA). Our primary endpoint was to compare the levels of serum fibrinogen between the two groups and find if there is a relationship between fibrinogen level and CA.
  
  
  RESULTS
  68 patients were diagnosed with UA and 47 with CA. Using a fibrinogen value of 885 mg/dl we found to be the best cut-off for predicting complicated appendicitis with a sensitivity of 86.77% (76.87-93.71 IC 95%), a specificity of 91.49 (83.51-99.46 IC 95%), a positive predictive value of 93.65 (95% CI 86.81-99.64) and, a negative predictive value of 82.69 (95% CI 65.73-87.84).
  
  
  CONCLUSIONS
  In the setting of a patient with a clinical diagnosis of AA, this study demonstrates fibrinogen as a good predictor factor for appendiceal perforation.
authors.affiliation: Department of General Surgery, Hospital Civil de Guadalajara, "Dr. Juan I. Menchaca", University of Guadalajara, Salvador de Quevedo no. 750, Guadalajara, Jalisco, Zip code 44100, Mexico.
authors.forename: F A
authors.initials: FA
authors.lastname: Alvarez-Alvarez
authors.affiliation: Department of Colorectal Surgery, Hospital Civil de Guadalajara, "Dr. Juan I. Menchaca", University of Guadalajara, Salvador de Quevedo no. 750, Guadalajara, Jalisco, Zip code 44100, Mexico; University Center of Tonalá, University of Guadalajara, Nuevo Periférico Av. 555, Tonalá, Jalisco, Zip code 48525, Mexico.
authors.forename: V M
authors.initials: VM
authors.lastname: Maciel-Gutierrez
authors.affiliation: University Center of Tonalá, University of Guadalajara, Nuevo Periférico Av. 555, Tonalá, Jalisco, Zip code 48525, Mexico.
authors.forename: A D
authors.initials: AD
authors.lastname: Rocha-Muñoz
authors.affiliation: Jackson Medical Group Specialty, 9195 Sunset Dr. Suite 230 Miami, FL, Zip code 33173, United States.
authors.forename: J H
authors.initials: JH
authors.lastname: Lujan
authors.affiliation: Department of General Surgery, Hospital Civil de Guadalajara, "Dr. Juan I. Menchaca", University of Guadalajara, Salvador de Quevedo no. 750, Guadalajara, Jalisco, Zip code 44100, Mexico. Electronic address: plonecef@gmail.com.
authors.forename: C F
authors.initials: CF
authors.lastname: Ploneda-Valencia
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001064:Appendicitis / Q000097:blood / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005340:Fibrinogen
keywords: Acute appendicitis; Complicated appendicitis; Fibrinogen