Appendicitis inflammatory response score: a novel scoring system for acute appendicitis
DOI:
https://doi.org/10.18203/2349-2902.isj20170863Keywords:
AIR score, Scoring acute appendicitisAbstract
Background: Acute appendicitis is one of the most common surgical emergencies encountered by doctors on call with emergency appendicectomy being a very common outcome of emergency laparotomies. There's been a marked decline in mortality over the past 50 years, but the rates of perforation and negative laparotomy have not changed much as they're influenced by factors untouched by technological advances.
Methods: A prospective comparative study to compare appendicitis inflammatory response score (AIR) and Alvarado scoring systems in evaluating suspected cases of acute appendicitis. 100 patients presenting with pain in the right lower quadrant of abdomen at the surgical clinics at Basaveshwar Teaching and General Hospital, Kalaburagi, Karnataka, India, who after clinical examination and relevant investigations were provisionally diagnosed to have acute appendicitis and warranted surgery for the same were evaluated using the scoring systems - Alvarado Score and Appendicitis Inflammatory Response Score. The scores were tallied and compared with final histopathology report. The study was conducted for a period of one and a half year.
Results: The results revealed that AIR (at score >4) demonstrated a higher sensitivity and specificity compared to Alvarado score (89.9 versus 78.6%) and (63.6 versus 54.5) respectively. Alvarado showed a slightly better sensitivity at score>8 (21.3 versus 12.3%).
Conclusions: The Appendicitis Inflammatory Response Score outperformed the Alvarado score. It holds promise to be incorporated into the clinician's daily inventory in efficiently diagnosing Appendicitis.
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References
Seal A. Appendicitis: a historical review. Can J Surg. 1981;24:427-33.
Flum DR, Koepsell T. The clinical and economic correlates of misdiagnosed appendicitis: nationwide analysis. Arch Surg. 2002;137(7):799-804.
Blomqvist PG, Andersson RE, Granath F, Lambe MP, Ekbom AR: Mortality after appendectomy in Sweden, 1987-1996. Ann Surg. 2001;233(4):455-60.
Hall EJ. Cancer risks from diagnostic radiology. Br J Radiol. 2008;81(965):362-78.
Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986;15:557-64.
Douglas CD, Macpherson NE, Davidson PM. Randomised controlled trial of ultrasonography in diagnosis of acute appendicitis, incorporating the Alvarado score. BMJ. 2000;321(7266):919-22.
Andersson RE. Meta-analysis of the clinical and laboratory diagnosis of appendicitis. Br J Surg. 2004;91:28-37.
Andersson M, Andersson RE. The appendicitis inflammatory response score: a tool for the diagnosis of acute appendicitis that outperforms the Alvarado score. World J Surg. 2008;32:1843-49.
Franke C, Bohner H, Yang Q: Ultrasonography for diagnosis of acute appendicitis: Results of a prospective multicenter trial. World J Surg. 1999:23:141.
Flum DR, Koepsell T. The clinical and economic correlates of misdiagnosed appendicitis: nationwide analysis. Arch Surg. 2002;137(7):799-804.
Blomqvist PG, Andersson RE, Granath F, Lambe MP, Ekbom AR. Mortality after appendectomy in Sweden, 1987-1996. Ann Surg. 2001;233(4):455-60.
De Castro SMM, Ünlü C, Steller EPH, Wagensveld BA, Vrouenraets BC. Evaluation of the appendicitis inflammatory response score for patients with acute appendicitis. World J Surg. 2012;36(7):1540-5.
Ohmann C, Franke C, Yang Q. Diagnostic score for acute appendicitis. Chirurg. 1995:66:135-41.
Enochsson L, Gudbjartsson T, Hellberg A. The Fenyo-Lindberg scoring system for appendicitis increases positive predictive value in fertile women a prospective study in 455 patients randomized to either laparoscopic or open appendectomy. Surg Endosc. 2004;18:1509-13.
Ohmann C, Franke C, Yang Q. Clinical benefit of a diagnostic score for appendicitis: results of a prospective interventional study. German Study Group of acute abdominal pain. Arch Surg. 1999;134:993-6.
Sammalkorpi HE, Mentula P, Leppäniemi A. A new adult appendicitis score improves diagnostic accuracy of acute appendicitis: a prospective study. BMC Gastroenterol. 2014;14:114.
Kim BS, Ryu DH, Kim TH, Jeong U, Song JH, Cho SI, et al. Diagnosis of acute appendicitis using scoring system: compared with the Alvarado score. J Korean Surg Soc. 2010;79:207-14.
Prout WG. The significance of rebound tenderness in acute abdomen. Brit J Surg. 1970:57:508-10.
Andersson RE. Meta-analysis of the clinical and laboratory diagnosis of appendicitis. Br J Surg. 2004;91:28-37.
Al-ajerami. Sensitivity and specificity of ultrasound in the diagnosis of acute appendicitis. East Mediterr Health J. 2012;18(1):66-9.
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