The Diagnostic Value Of Preoperative Fibrinogen Combined With RIPASA Score In The Severity Of Acute Appendicitis

Objective Toinvestigate the diagnosis value of preoperative fibrinogen combined with RIPASA score inthe severity of acute appendicitis.Methods We retrospectively analyze 256 patients with postoperatively histologically proved acute appendicitis who underwent laparoscopic or open appendectomy from December 2014 to September 2016 in the general surgery department of Xi'an Gaoxin Hospital.According to the pathological results,those patients were divided into theacute simple appendicitis group(32 cases)? theacute suppurative appendicitis group(176 cases)? and the acute gangrenous/perforated appendicitis group(48 cases),the level of fibrinogen of them was detected by automatic blood coagulation analyzer,and meanwhile evaluate the preoperative RIPASA score of them.Results Receiver operating characteristic curve analysis showed that the area under curve?the sensitivity and the specificity of preoperative fibrinogen combined with RIPASA score in diagnosis of acute gangrene/perforation appendicitis respectively is 0.817(P< 0.0001)?75%(95%CI 60.4~86.4)and 78%(95%CI 72.7~84.2);that the area under curve?the sensitivity and the specificity of preoperative fibrinogen combined with RIPASA score in diagnosis of acute complicated appendicitis(including acute suppurative appendicitis group and acute gangrenous/perforated appendicitis group)respectively is 0.944(P< 0.0001)? 81.25%(95%CI 75.5~86.1)and 100%(95%CI 89.1~100.0).Conclusions Preoperative fibrinogen combined with RIPASA score has a high diagnostic value for acute complicated appendicitis,and has a certain diagnostic value for acute gangrenous appendicitis,which is helpful to evaluate the severity of acute appendicitis before operation.