Comparative Study Between Diagnostic Accuracy of Serum Bilirubin Levels Versus C-Reactive Protein in Evaluation of Complicated Acute Appendicitis

Objective: To compare the diagnostic accuracy of serum bilirubin levels versus C-Reactive Protein in evaluation of complicated acute appendicitis. Study Design: Quasi-experimental study. Place and Duration of Study: Department of General Surgery, Combined Military Hospital, Rawalpindi Pakistan, from Mar to Oct 2022. Methodology: Using non-probability consecutive sampling technique, a total of 122 cases of acute appendicitis were enrolled in the study. Emergency appendectomy was performed, and cases were categorized as per operative findings into two groups: Group-A (uncomplicated) and Group-B (complicated) appendicitis. Pre-operative values of serum total bilirubin and C-Reactive Proteins were compared for both groups using IBM SPSS version 26.0. Results: We analyzed the data for a total of 122 cases of acute appendicitis, among which 86(70.5%) were males and 36(29.5%) were females and 87(71.3%) patients had uncomplicated appendicitis while 35(28.7%) had complicated appendicitis. Sensitivity, specificity, Positive Predictive Value and Negative Predictive Value for serum total bilirubin were found to be 28.6%, 90.8%, 55.6%, and 75.9% respectively, while for C-Reactive Protein were 94.3%, 34.5%, 36.7%, and 93.7%, respectively. For complicated appendix, the most reliable indicator found in our study was, serum total bilirubin, which showed the highest specificity and Positive Predictive Value. Conclusion: Serum total bilirubin levels, when raised in cases of acute appendicitis, are a strong indicator of the presence of complicated appendicitis, warranting aggressive