Predicting Acute Appendicitis? A comparison of the Alvarado Score, the Appendicitis Inflammatory Response Score and Clinical Assessment

• Published in: World journal of surgery 2015, Vol.39 (1), p.104-109
• Main Authors: Kollár, D., McCartan, D. P., Bourke, M., Cross, K. S., Dowdall, J.
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Acute Appendicitis; Adolescent; Adult; Appendicitis; Appendicitis - diagnosis; Cardiac Surgery; Clinical Prediction Rule; Decision Making; False Negative Rate; Female; General Surgery; Humans; Male; Medicine; Medicine & Public Health; Negative Appendectomy; Original Scientific Report; Pain Measurement; Predictive Value of Tests; Retrospective Studies; Severity of Illness Index; Surgery; Thoracic Surgery; Vascular Surgery; Young Adult
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-014-2794-6

Background Patients presenting with suspected appendicitis pose a diagnostic challenge. The appendicitis inflammatory response (AIR) score has outperformed the Alvarado score in two retrospective studies. The aim of this study was to evaluate the AIR Score and compare its performance in predicting risk of appendicitis to both the Alvarado score and the clinical impression of a senior surgeon. Methods All parameters included in the AIR and Alvarado scores as well as the initial clinical impression of a senior surgeon were prospectively recorded on patients referred to the surgical on call team with acute right iliac fossa pain over a 6-month period. Predictions were correlated with the final diagnosis of appendicitis. Results Appendicitis was the final diagnosis in 67 of 182 patients (37 %). The three methods of assessment stratified similar proportions (~40 %) of patients to a low probability of appendicitis ( p  = 0.233) with a false negative rate of