Publication:

Serum fibrinogen level as a diagnostic tool in diagnosis of acute appendicitis

Background Objective of present study was to evaluate the importance of serum fibrinogen level in diagnosis of acute appendicitis and relation between clinical examination, ALVARADO score, USG Abdomen and Histopathological examination in operated case of acute appendicitis.

Methods This prospective randomized study was done in SSG Hospital and government medical college, Vadodara in August 2016 to December 2016, Symptoms, signs, duration of symptoms, and laboratory investigations along with ultrasound of abdomen were recorded; Alvarado score was calculated and recorded in all the cases, serum fibrinogen levels were measured before surgery. After undergoing definitive surgery histopathological report of specimen of appendix were obtained and the ultimate diagnosis was kept on the basis of histopathological results. Data were recorded using Microsoft Excel, on the basis of histopathological diagnosis two groups were formed one of acute appendicitis another of non-appendicitis. Sensitivity, specificity, accuracy along with negative and positive predictive value was calculated. chi square test was used for calculation of p value, p value of <0.05 was considered significant.

Results During the study period, 213 patients underwent surgery for suspected acute appendicitis. Appendicitis was confirmed in 198 (93%) patients. Out of which 135 (63.4%) patients were male and 78 (36.6%) female. The best diagnostic cut-off point for fibrinogen was found at 300 mg/dl, for Alvarado score at 7.

Conclusions The use of fibrinogen blood level may be a new diagnostic modality in the diagnosis of acute appendicitis. The formulation of a triple test is recommended as a criteria in deciding emergency surgery.