Are scoring systems detecting acute appendicitis reliable? a prospective clinical study

Abstract

Aim: The diagnosis of acute appendicitis is still challenging. Negative appendectomy rate is reported as 20-30%. Therefore, various scoring systems have been developed to prevent unnecessary appendectomies. The aim of our study is to analyze the diagnostic value of different scoring systems in acute appendicitis. Material and Method: The study conducted with 200 consecutive patients who were operated with the diagnosis of acute appendicitis. After the admission and deciding the operation via experienced general surgeon, the probability of acute appendicitis was calculated using via 6 different scoring systems: Alvarado, Eskelinen, Ohmann, Lintula, RIPASA, Fenyo, respectively, and results were analyzed statistically. p<0.05 was considered statistically significant. Results: RIPASA had the highest sensitivity (83.8%) and accuracy (78%) ratio in all patient groups; The Lintula scoring system had the highest specificity (66.7%). Sensitivity values were found to be higher in males, and the sensitivity of Lintula (44.6%/12.6%; p: 0.001) and Fenyo (67.6%/19.4%; p<0.001) scores were significantly higher in males. The spesificity value was significantly higher for Eskelinen (85.7%/35.7%; p: 0.031) and Lintula (100%/50%; p: 0.022) in females. Conclusion: RIPASA is the scoring system with the highest sensitivity for both genders. Eskelinen and Lintula is noteworthy in females. We believe that the use of scoring tests with classifying according to gender may lead to a decrease in negative appendectomies.

Keywords

• Acute Appendicitis
• Scoring Systems
• Appendectomy
• Clinical decision

References

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