Prospective Comparison of the Efficacy of Two Common Appendicitis Scoring Systems: Is Combination a Solution?
Journal Title: Turkish Journal of Colorectal Disease - Year 2020, Vol 30, Issue 2
Abstract
Aim: The diagnosis of acute appendicitis mostly relies on history taking and physical examination findings supported by laboratory and imaging studies. A number of different diagnostic scoring systems have been developed to facilitate diagnosis, and their accuracies vary among patient populations. This prospective study aims to evaluate the accuracy of the two most frequently used scoring systems in the Turkish patient population and to analyse the possible diagnostic advantage of using these two systems in combination. Method: Patients admitted to the emergency department of a tertiary healthcare centre with acute abdominal pain who eventually underwent appendectomy between July 2018 and January 2019 were enrolled in the study. Alvarado and Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scores, as well as other laboratory parameters, were recorded for each patient. Using histopathologic examination as the gold standard, the sensitivity, specificity and positive and negative predictive values of each scoring system were calculated and combined using McNemar’s x2 test. Results: Data from a total of 203 patients were analysed. The sensitivity of the RIPASA system (95%) was far superior to that of the Alvarado system (35.6%). However, the Alvarado scoring system had much higher diagnostic specificity than the RIPASA system (80% vs 33.3%). The combined sensitivity and specificity of the tests rose to 88% and 62.5%, respectively. Conclusion: The RIPASA system has high sensitivity; however, the Alvarado system has high specificity for the Turkish population. Both the Alvarado and RIPASA scoring systems are useful clinical tools with different strengths. Using these two systems in combination increases diagnostic power by combining the strongest aspects of both tests.
Authors and Affiliations
Mehmet Üstün, Avni Can Karaca, Semra Demirli Atıcı, Göksever Akpınar, Cem Karaali
Keywords
Related Articles
- EP ID EP684935
- DOI 10.4274/tjcd.galenos.2020.2020-1-6
- Views 166
- Downloads 0
Type 4 Congenital Pouch Colon without Fistula with Anal Agenesis and Lower Vaginal Agenesis in a Female Fetus: A Rare Autopsy Case Report
Congenital pouch colon is a rare anorectal malformation of unknown embryogenesis in which all or part of the large intestine is replaced by a pouch-like dilatation that usually communicates with the urogenital tract via...
Pelvic Exenteration for Recurrent Rectal Cancer: A Single Institution Experience
Aim: Rectal cancer is an important cause of cancer-related deaths worldwide (1-2). Although rectal cancers can be diagnosed earlier nowadays due to the development of screening programmes, 18% of patients have a locally...
Iatrogenic Colon Perforation Due to Colonoscopy Presenting as a Diffuse Subcutaneous Emphysema
Colonoscopy is a procedure frequently used for the screening, diagnosis and treatment of colorectal diseases. While colonoscopy is generally accepted as a safe procedure, it may lead to morbidity and mortality with serio...
Melanosis Coli: Case Report
Melanosis coli is an incidental benign finding characterized by the deposition of dark brown pigment in the colonic mucosa. The cause of this situation is due to long-term laxative use. We report a female patient who und...
Intussusception Caused by an Appendiceal Mucocele: Case Report
Intussusception of the appendix in to the caecum caused by an appendiceal mucocele is a rarecondition. Acute appendicitis is the most common presentation is of the disease. Radiologic examination methods especially compu...