Hyperbilirubinemia is a predictor of appendiceal perforation in children: A meta-analysis

[eng] Objective: In this meta-analysis, our goal was to examine the diagnostic utility of bilirubin in identifying complicated from uncomplicated pediatric appendicitis. Materials and methods: Using the databases Embase, PubMed, Scopus, and Cochrane, we carried out a thorough literature search up to 2022. Studies comparing complicated appendicitis (CA) and simple appendicitis (SA) in terms of hyperbilirubinemia in the pediatric population were included. Results: A total of 5 studies with 2740 acute appendicitis patients (1097 complicated appendicitis and 1643 simple appendicitis) were included in this meta-analysis. Five studies have discussed the diagnostic value of total bilirubin (TB). When compared to simple appendicitis, complicated appendicitis had a significantly higher TB count (I2=94%), (WMD=0.18, 95% CI -0.00 to 0.37; P=0.05), DB count (I2=0%), (WMD=0.11, 95% CI 0.04 to 0.18; P=0.002), and IB count (I2= not applicable), (WMD=0.04, 95% CI 0.01 to 0.07; P=0.02). Conclusions: In conclusion, in this meta-analysis, total bilirubin, direct bilirubin, and indirect bilirubin values were higher in complicated appendicitis compared to simple appendicitis. Both total bilirubin and direct bilirubin can be used as diagnostic parameters in childhood appendicitis to differentiate complicated appendicitis from simple appendicitis.
[spa] Objetivo: En este metanálisis, nuestro objetivo fue examinar la utilidad diagnóstica de la bilirrubina para identificar la apendicitis pediátrica complicada frente a la no complicada. Materiales y métodos: Utilizando las bases de datos Embase, PubMed, Scopus y Cochrane, realizamos una búsqueda bibliográfica exhaustiva hasta 2022. Se incluyeron estudios que compararan apendicitis complicada (AC) y apendicitis simple (AS) en términos de hiperbilirrubinemia en la población pediátrica. Resultados: Se incluyeron en este metanálisis un total de 5 estudios con 2740 pacientes con apendicitis aguda (1097 complicada y 1643 simple). Cinco estudios han discutido el valor diagnóstico de la bilirrubina total (TB). En comparación con la apendicitis simple, la apendicitis complicada tuvo un recuento de TB significativamente mayor (I2=94 %), (DMP=0,18, IC del 95 %: -0,00 a 0,37; P=0,05), recuento de DB (I2=0 %), (DMP = 0,11, IC del 95 %: 0,04 a 0,18; P = 0,002) y recuento de BI (I2 = no aplicable), (DMP = 0,04, IC del 95 %: 0,01 a 0,07; P = 0,02). Conclusiones: Tanto la bilirrubina total como la directa pueden usarse como parámetros de diagnóstico en la apendicitis infantil para diferenciar la apendicitis complicada de la apendicitis simple.