Max appendicitis score: a new diagnostic score for diagnosing acute appendicitis

Authors

  • Vidur Jyoti Department of General Surgery, Max Superspeciality Hospital, Gurgaon, Haryana, India
  • Akhilesh Kumar Department of Internal Medicine, Max Superspeciality Hospital, Gurgaon, Haryana, India
  • Preeti Yadav Department of General Surgery, Max Superspeciality Hospital, Gurgaon, Haryana, India
  • Vaibhav Kapoor Department of General Surgery, Max Superspeciality Hospital, Gurgaon, Haryana, India

DOI:

https://doi.org/10.18203/2349-2902.isj20173889

Keywords:

Acute appendicitis, Alvarado scoring system, Max appendicitis score, Negative appendicectomy

Abstract

Background: Scoring systems are valuable and valid for discriminating between acute appendicitis and nonspecific abdominal pain. Alvarado scoring is classical and different modifications of Alvarado score have been introduced but none is ideal and negative appendicectomy rate is still high. The aim of the study is to design a more reliable scoring system which is cost effective, simple, easy to learn, high accuracy, which can be applied by any doctor at any health care facility.

Methods: Retrospective study of 160 patients hospitalized with abdominal pain suggestive of acute appendicitis and subsequently operated over a period of 5 year from January 2012 to January 2017 at Max Super Speciality Hospital, Gurgaon.

Results: In the present study based on six clinically most significant variables, a diagnostic accuracy of 96.25% was achieved while the same was 85% for classical Alvardo Score. This significantly increased the diagnostic accuracy and lowered the negative appendicectomy rate.

Conclusions: Max Appendicitis Score is perfect scoring system for diagnosing appendicitis, it can be specially very handy in peripheral health centers where radiological facilities are sparse.

References

Williams NS, Bulstrode CJK, O’Connell PR. The vermiform appendix. Bailey and Love’s Short practice of Surgery. 25th edition. 2008;67:1204-18.

Omari AH, Khammas MR. Acute appendicites in elderly: risk factor for perforation. World J Emerg Surg. 2014;9:6.

Fitz RH. Perforating inflammation of the vermiform appendix with special reference to its early diagnosis and treatment. Am J Med Sci. 1886;92:32-46.

Peterson MC, Holbrook JH, Von Hales DE, Smith NL, Staker LV. Contributions of the history, physical examination, and laboratory investigation in making medical diagnoses. West J Med. 1992;156(2):163-5.

Dado G, Anaina G, Baccarani U. Application of a clinical score for the diagnosis of acute appendicitis in childhood. J Pediatr Surg. 2000;35:1320-2.

Wagner JM, McKinney WP, Carpenter JL. Does this patient have appendicitis?. JAMA. 1996; 276:1589-94.

Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986;15:557-64.

Owen TD, William H, Stiff G, Jinkinsen LR, Rees BI. Evaluation of Alvarado score in acute appendicitis. J R Soc Med. 1992;85:87-8.

Ohmann C, Yang O, Frank C. Diagnostic score for acute appendicitis. Abdominal pain study group. Eur J Surg. 1995;161:273-81.

Macklin CP, Radcliffe GS, Merei JM, Stringer MD. A prospective evaluation of modified Alvarado score for acute appendicitis in children. Ann R Coll Surg Engl. 1997;79:203-205.

Al Hashemy AM, Seleem MI. Appraisal of the modified Alvarado score for acute appendicitis adults. Saudi Med J. 2004;25:1229-31.

Jang SO, kim BS, Moon DJ. Application of Alvarado score in patients with suspected appendicitis. Korean J Gastroenterol. 2008;52:27-31.

Ohmann C, Yang Q, Franke C. The abdominal pain study group. Diagnostic scores for acute appendicitis. Eur J Surg. 1995;161:273-81.

Van Randen A, Bipat S, Zwinderman AH, Ubbink DT, Stoker J, Boermeester MA. Acute appendicitis: meta-analysis of diagnostic performance of CT and graded compression US related to prevalence of disease. Radiol. 2008;249:97-106.

Marwah K, Mukesh MK, Atul K, Vijay A, Deepak K, Atul J, et al. Significance of Ripasa scoring system in diagnosis of acute apppendicitis. 2015;3(1):4-10.

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Published

2017-08-24

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Section

Original Research Articles