Akurasi Total Hitung Leukosit dan Durasi Simtom sebagai Prediktor Perforasi Apendisitis pada Penderita Apendisitis Akut

Abstract

Perforation is frequently observed among acute appendicitis patients, which characterized by high fever and increased leucocyte level. The aim of this study is to determine the accuracy of total leucocyte count (TLC) and symptom duration (SD) as predictors of perforation in acute appendicitis patients. A retrospective cross sectional study was conducted and 96 acute appendicitis patients were enrolled in the study. The subjects were selected based on consecutive method taken from inpatient register of 2014 -2015 of Sanjiwani Hospital at Gianyar. Demographic data, SD and TLC were collected from medical record. Perforation was diagnosed based on the result of pathology and anatomy examinations. Chi square test and Poisson regression method were performed to analyze the association between TLC, SD and incidence of perforation. Positive predictive value (PPV) and Negative predictive value (NPV) were also calculated to measure the level of accuracy of the predictors. Results show that Relative Risk (RR) of TLC (>18.000/ml:≤18.000/ml) was 2.9 (1.2 – 6.7) whereas RR of SD (>24hours:≤24hours) was 2.3 (1.1 – 4.9). PPV/NPV of TLC, SD and TLC&SD combination were 59.4/93.8; 52.9/91.9; and 82.4/88.4, respectively. As conclusion, TLC&SD combined has high accuracy as predictor of perforation in acute appendicitis patients.

Keywords

• apendisitis perforation
• total leucocyte count
• time duration