仅高胆红素血症无法鉴别急性阑尾炎中的穿孔情况。
Hyperbilirubinaemia alone cannot distinguish a perforation in acute appendicitis.
作者信息
Silva Fábio R, da Rosa Maria Inês, Silva Bruno R, Simon Carla, Alexandre Maria Cecília, Medeiros Lidia R, Bitencourt Fabrício S, dos Reis Maria Eduarda Fernandes
机构信息
Medical Residency, São José Hospital, Criciuma, Santa Catarina, Brazil.
Postgraduate Program in Health Sciences, Laboratory of Epidemiology, University of Extremo Sul Catarinense, Criciuma, Santa Catarina, Brazil.
出版信息
ANZ J Surg. 2016 Apr;86(4):255-9. doi: 10.1111/ans.12989. Epub 2015 Feb 2.
BACKGROUND
The objective of the study was to verify the accuracy of hyperbilirubinaemia as a marker for acute perforated appendicitis.
METHODS
A comprehensive search of the MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, IBECS, BIOSIS, Web of Science, SCOPUS, Congress Abstracts and Grey literature from January 1969 to July 2014. We included cross-sectional and cohort studies, prospective and retrospective, which evaluated hyperbilirubinaemia level in perforated appendicitis and compared them with histological analysis of all appendectomy specimens.
RESULTS
Eleven studies were analysed, which included 5395 patients. Pooled sensitivity was 54.6% (95% confidence interval (CI), 42.8-65.8) and specificity was 70.0% (95% CI, 54.7-81.9%) using STATA. The diagnostic odds ratio was 2.82 (95% CI, 1.38-5.72%). Summary receiver operating characteristic curves were constructed. The area under the curve was 0.65.
CONCLUSION
This meta-analysis showed that the value of hyperbilirubinaemia alone cannot predict acute perforated appendicitis.
背景
本研究的目的是验证高胆红素血症作为急性穿孔性阑尾炎标志物的准确性。
方法
全面检索1969年1月至2014年7月的MEDLINE（PubMed）、EMBASE、Cochrane对照试验中央注册库、IBECS、BIOSIS、科学网、SCOPUS、会议摘要和灰色文献。我们纳入了横断面研究和队列研究，包括前瞻性和回顾性研究，这些研究评估了穿孔性阑尾炎患者的高胆红素血症水平，并将其与所有阑尾切除标本的组织学分析结果进行比较。
结果
分析了11项研究，共纳入5395例患者。使用STATA软件分析得出，合并敏感度为54.6%（95%置信区间（CI），42.8 - 65.8），特异度为70.0%（95%CI，54.7 - 81.9%）。诊断比值比为2.82（95%CI，1.38 - 5.72%）。构建了汇总的受试者工作特征曲线。曲线下面积为0.65。
结论
该荟萃分析表明，仅高胆红素血症的值不能预测急性穿孔性阑尾炎。
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