Predictive value of scoring systems for the diagnosis of acute appendicitis in emergency department patients: Is there an accurate one?

Background: Acute appendicitis is one of the challenging surgical conditions presented in the emergency departments. Clinical scoring systems were developed to reduce the negative appendectomy rate and also to avoid unnecessary diagnostic evaluation. Objectives: The primary aim was to compare the cl...

Full description

Saved in:
Bibliographic Details
Published in:Hong Kong journal of emergency medicine 2020-09, Vol.27 (5), p.262-269
Main Authors: Ak, Rohat, Doğanay, Fatih, Unal Akoğlu, Ebru, Akoğlu, Haldun, Uçar, Aslı Bahar, Kurt, Erdem, Arslan Turan, Cansu, Onur, Ozge
Format: Article
Language:English
Subjects:
abdominal pain
Acute Inflammatory Response
Alvarado
Appendicitis
Care
Clinical medicine
Diagnosis
Emergency medical care
Evaluation
Examinations
Medical care
Medical diagnosis
Pain
Patients
Raja Isteri Pengiran Anak Saleha Appendicitis
Surgery
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: Acute appendicitis is one of the challenging surgical conditions presented in the emergency departments. Clinical scoring systems were developed to reduce the negative appendectomy rate and also to avoid unnecessary diagnostic evaluation. Objectives: The primary aim was to compare the clinical adequacy of the Alvarado, Acute Inflammatory Response, and the Raja Isteri Pengiran Anak Saleha Appendicitis scores in patients with right lower quadrant pain for the diagnosis of acute appendicitis. Methods: This was a prospective and observational study. All patients over the age of 18 years who presented with a complaint of right lower quadrant pain were enrolled. The Alvarado, Acute Inflammatory Response, and Raja Isteri Pengiran Anak Saleha Appendicitis scoring systems were compared. The patients were either admitted or followed-up as out-patient. Face-to-face or telephone follow-up visits were arranged for the patients who did not have surgery and who were not admitted. Results: 232 patients were included and 14 patients were excluded from the study. Of the 218 patients, 114 patients underwent surgery. Of the 114 patients, 107 patients were pathologically diagnosed with acute appendicitis. It was determined that Raja Isteri Pengiran Anak Saleha Appendicitis score was the most valuable score with 0.88 accuracy, followed by Acute Inflammatory Response (area under the curve = 0.79) and Alvarado (area under the curve = 0.71) scores.
ISSN:1024-9079
2309-5407
DOI:10.1177/1024907919840175