title: [Hyperbilirrubinemia as a predictive factor of perforated appendicitis].
abstract: BACKGROUND
  Recent studies considered hyperbilirubinemia as a marker to identify the presence of perforated appendix. The aim of the study is to verify that the presence of hyperbilirubinemia is a useful marker to identify the presence of perforated appendix before surgery, and thereby, provide early treatment to avoid progression of the disease and its complications.
  
  
  METHODS
  This is a retrospective study, which identified 225 patients, who met the inclusion and exclusion criteria, from January 2012 to October 2014 at the IMSS General Hospital 29, taking into account laboratory results and postoperative, performing a univariate, bivariate and multivariate analysis.
  
  
  RESULTS
  56.9% showed bilirubin < 1, from which 16.4% presented perforation, while 43.1% showed bilirubin > 1, 62.88% presented perforated appendicitis. Hyperbilirubinemia increases 17 times the risk of perforated appendix (RMP: 17.63; IC 95%: 6.882-45.207; p < 0.001) which is statistically significant.
  
  
  CONCLUSIONS
  Considering the limitations of this study, it can be inferred that hyperbilirubinemia is present in a great number of patients with perforated appendicitis, so it could be considered a relevant laboratory test to include within the protocol of appendicitis, which in turn, may determine a better planning for the surgical approach.
authors.affiliation: Departamento de Epidemiología, Unidad de Medicina Familiar 29, Instituto Mexicano del Seguro Social, Ciudad de México, México. biancalanis@hotmail.com.
authors.forename: Bianca
authors.initials: B
authors.lastname: Alanis-Rivera
authors.forename: Luis Abraham
authors.initials: LA
authors.lastname: Zúñiga-Vázquez
authors.forename: María Carmen
authors.initials: MC
authors.lastname: Silva-Escamilla
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D001663:Bilirubin / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006932:Hyperbilirubinemia / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001663:Bilirubin
keywords: Appendicitis; Appendix; Hyperbilirubinemia