RISK STRATIFICATION USING APPENDICITIS INFLAMMATORY RESPONSE SCORE, A USEFUL TOOL TO REDUCE NEGATIVE APPENDICECTOMY RATE : OUR EXPERIENCE
Journal Title: IJSR-International Journal Of Scientific Research - Year 2019, Vol 8, Issue 5
Abstract
Background: Acute appendicitis is mostly considered a clinical diagnosis and many surgeons resort to clinical judgement for deciding its management. Such cases often pose a diagnostic dilemma and result in significant negative exploration rates. Appendicitis Inflammatory Response (AIR) score, designed in 2008, is a validated clinical scoring system which has outperformed the well-known Alvarado scoring system. This study evaluates the risk stratification of patients as per AIR scores, correlation with the post-op histopathological examination (HPE) diagnosis to calculate the negative appendicectomy rate and to evaluate the diagnostic performance of this scoring system. Method: This is a prospective observational study carried out between Nov 2016 and May 2018, on 150 cases of acute appendicitis that underwent surgical management. Result: This study data revealed a negative appendicectomy rate of 9.33 %. Statistical analysis showed that scores of 9 - 12 has great accuracy for diagnosis, with a specificity of 100 % and positive predictive value of 1.0 whereas low scores of 0-4 potentially identify cases who do not require surgery. Conclusion: The AIR score is an accurate diagnostic tool when a score of 9 is taken as cut-off. Management algorithms based on AIR score have the potential of reducing negative appendicectomy rate by correct identification of those who don't require surgery.
Authors and Affiliations
Vikrant Singh*, SS Jaiswal
Keywords
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