Evidence map›Paper›PMID 37950198›Full record

Observational studyBMC surgery2023

Elevated total and direct bilirubin are associated with acute complicated appendicitis: a single-center based study in Saudi Arabia.

Mohammed S Alfehaid, Ayman M Babiker, Abdullah Hamad Alkharraz, Hamad Yousef Alsaeed, Ali Abdullah Alzunaydi, Adi Abdulaziz Aldubaiyan, Hanan Abdalla Sinyan, Bshayr K Alkhalaf, Rakan Alshuwaykan, Rehana Khalil and 1 more

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Pro-adrenomedullin: a novel diagnostic biomarker of acute appendicitis.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026
    Article
  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Mohammed S AlfehaidDepartment of Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia.
Ayman M BabikerKing Saud Hospital, Ministry of Health, Unaizah, Saudi Arabia.
Abdullah Hamad AlkharrazResearch unit, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia.
Hamad Yousef AlsaeedResearch unit, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia.
Ali Abdullah AlzunaydiResearch unit, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia.
Adi Abdulaziz AldubaiyanResearch unit, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia.
Hanan Abdalla SinyanKing Saud Hospital, Ministry of Health, Unaizah, Saudi Arabia.
Bshayr K AlkhalafKing Saud Hospital, Ministry of Health, Unaizah, Saudi Arabia.
Rakan AlshuwaykanKing Saud Hospital, Ministry of Health, Unaizah, Saudi Arabia.
Rehana KhalilDepartment of Family and Community Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia.
Osama Al-WutaydDepartment of Family and Community Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia. o.alwutayd@qu.edu.sa.
Qassim University · SAMinistry of Health · SA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAppendicitis is the most common abdominal surgical emergency and up to our knowledge no previous studies have been conducted in Saudi Arabia particularly at Qassim region and this study aimed to determine a total and direct bilirubin as a predictor of acute complicated appendicitis.

methodsObservational retrospective study that included patients admitted under the general surgery department with a diagnosis of acute appendicitis at King Saud Hospital, Unaizah, Saudi Arabia. Data on age, gender, BMI, diabetes mellitus, total and direct bilirubin, AST, ALT, sodium, and WBCs levels were obtained.

resultAmong the overall study population of 158 patients, the age median [IQR] was 24.5 [19-31], males were 99 (62.7%), and complicated appendicitis was 33 (20.9%). The multivariable analysis revealed that both elevated total and direct bilirubin are associated with complicated appendicitis (aOR = 3.79, 95% CI: 1.67-8.48, P = 0.001) and (aOR = 4.74, 95% CI: 2.07-10.86, P < 0.001) respectively. A receiver operating characteristic curve showed the best cutoff value of total and direct bilirubin as ≥ 15 µmol/L and ≥ 5 µmol/L respectively, with a sensitivity of 57.6%, and specificity of 73.6% for elevated total bilirubin, and a sensitivity of 54.6%, and specificity of 80% for elevated direct bilirubin.

conclusionElevated total and direct bilirubin are associated with acute complicated appendicitis in this setting. However, it should be supportive factor for acute complicated appendicitis and not considered as standalone diagnostic test.

Indexed as

AppendicitisAcute DiseaseBilirubinHumansMaleRetrospective StudiesROC CurveSaudi ArabiaBilirubinAppendicitisBilirubinDirect bilirubinObservational studySaudi ArabiaWBCs

Identifiers

PMID37950198
PMCPMC10638704
OpenAlexW4388562471

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.