Evaluation of Diagnostic Scores for Acute Appendicitis

J Coll Physicians Surg Pak. 2018 Feb;28(2):110-114. doi: 10.29271/jcpsp.2018.02.110.

Abstract

Objective: To assess the sensitivity of the Alvarado score (AS), modified Alvarado score (MAS), Fenyo-Lindberg score (FS), Lintula score (LS), Eskelinen score (ES), Teicher score (TS), and Christian score (CS) [seven scorings] in patients with acute appendicitis (AA).

Study design: Analytical study.

Place and duration of study: The First Affiliated Hospital of Chongqing Medical University, China, from January 2012 to June 2015.

Methodology: Patients with diagnosis of AA were evaluated retrospectively to compare the scoring systems. The diagnostic sensitivity (the correct number of diagnoses divided by the total number) was compared. Data were analyzed using SPSS software.

Results: One hundred and seventy-nine patients were studied. The sensitivity of AS was 92.7%; It outperformed each of the other scores. The sensitivity of FS, LS, and TS in women was lower than that in men (p=0.016, p<0.001, and p<0.001, respectively). The sensitivity of the FS, ES, TS, and CS in patients with a duration of illness greater than 48 hours was lower than that in patients with a duration of illness less than 48 hours (p<0.001 for all).

Conclusion: AS is the most useful and sensitive diagnostic tool for AA. FS, LS, and TS had a lower diagnostic sensitivity in women; and FS, ES, TS, and CS had a low sensitivity in patients with a duration of illness greater than 48 hours.

Publication types

  • Evaluation Study

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Appendicitis / diagnosis*
  • China
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement*
  • Predictive Value of Tests
  • Retrospective Studies
  • Sensitivity and Specificity
  • Vomiting / etiology
  • Young Adult