The Value of Scoring Systems for the Diagnosis of Acute Appendicitis

• Authors: Dominik A. Walczak , Dariusz Pawełczak , Agata Żółtaszek , Rajmund Jaguścik , Wojciech Fałek , Monika Czerwińska , Karolina Ptasińska , Piotr W. Trzeciak , Zbigniew Pasieka
• Languages of publication: EN

Abstracts

EN

Accurate diagnosis of acute appendicitis (AA) is still a problem and is not always easy, even for experienced surgeons. Studies have shown that 20 to 30% of the appendices removedwere normal. Therefore, various scoring systems have been developed to aid in the diagnosis of doubtful cases and reduce the number of unnecessary appendectomies. The aim of this study was to assess the diagnostic value of different scoring systems in acute appendicitis. Material and methods. The study involved 94 patients who underwent laparotomy due to suspected acute appendicitis. Medical examination at hospital admission was performed by a resident and a general surgery specialist. The probability of AA was evaluated using six different scoring systems: Alvarado, Fenyo, Eskelinen, Ohman, Tzankis, and RIPASA. The resident calculated the results in individual systems. The decision to perform the operation was taken by a specialist surgeon who did not know the results. Results. Normal appendix was removed in 26% of cases. Eskelinen, RIPASA and Alvarado systems showed highest sensitivity (99%, 88% and 85%, respectively). Tzankis and Fenyo systems showed highest specificity (62% and 50%, respectively). Conclusions. Our study has shown limited value of scoring systems for the diagnosis of acute appendicitis. The systems may improve diagnostic accuracy as they require obtaining a more detailed medical history, and making a more thorough and organized data analysis. However, the scoring systems should be treated only as an aid to diagnosis

Keywords

EN

acute appendicitis; scoring systems; diagnosis; appendectomy; symptoms; signs

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2015
• Volume: 87
• Issue: 2
• Pages: 65-70

Dates

published

1 - 2 - 2015

online

3 - 7 - 2015

Contributors

author

Dominik A. Walczak

• Department of General Surgery, John Paul II Memorial Hospital in Bełchatów1 Ordynator: lek. P. W. Trzeciak / Department of Experimental Surgery, Medical University in Łódź2 Kierownik: dr hab. Z. Pasieka, prof. nadzw.

author

Dariusz Pawełczak

• Department of Experimental Surgery, Medical University in Łódź2 Kierownik: dr hab. Z. Pasieka, prof. nadzw.

author

Agata Żółtaszek

• Department of Spatial Econometrics, Faculty of Economics and Sociology, University in Łódź3 Kierownik: prof. dr hab. J. Suchecka

author

Rajmund Jaguścik

• Department of General Surgery, John Paul II Memorial Hospital in Bełchatów1 Ordynator: lek. P. W. Trzeciak

author

Wojciech Fałek

• Department of General Surgery, John Paul II Memorial Hospital in Bełchatów Ordynator: lek. P. W. Trzeciak

author

Monika Czerwińska

• Department of General Surgery, John Paul II Memorial Hospital in Bełchatów Ordynator: lek. P. W. Trzeciak

author

Karolina Ptasińska

• Department of General Surgery, John Paul II Memorial Hospital in Bełchatów Ordynator: lek. P. W. Trzeciak

author

Piotr W. Trzeciak

• Department of General Surgery, John Paul II Memorial Hospital in Bełchatów Ordynator: lek. P. W. Trzeciak

author

Zbigniew Pasieka

• Department of Experimental Surgery, Medical University in Łódź2 Kierownik: dr hab. Z. Pasieka, prof. nadzw.

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Identifiers

DOI

10.1515/pjs-2015-0021