Diagnosis of Acute Appendicitis Using Scoring System : Compared with the Alvarado Score :Compared with the Alvarado Score

Bin Soo Kim; Dong Hee Ryu; Tae Hwa Kim; Il Ung Jeong; Jun Ho Song; Sung Il Cho; Jin Kweon Kim; Yong Sik Jeong; Sang Jeon Lee

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자료유형: 학술저널

저자정보: Bin Soo Kim (충북대학교병원) Dong Hee Ryu (충북대학교병원) Tae Hwa Kim (충북대학교병원) Il Ung Jeong (청주성모병원) Jun Ho Song (청주성모병원) Sung Il Cho (청주성모병원) Jin Kweon Kim (효성병원) Yong Sik Jeong (효성병원) Sang Jeon Lee (충북대학교병원)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research 대한외과학회지 Vol.79 No.3

발행연도: 2010.9

수록면: 207 - 214 (8page)

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Purpose: This study evaluated the usefulness of a new scoring system in diagnosing acute appendicitis which expresses the patient’s symptoms, physical examination, and laboratory findings more clearly and objectively.
Methods: A prospective study was conducted with 314 patients who were hospitalized with suspicion of acute appendicitis. After analyzing the symptoms, physical examination, and laboratory findings, 10 meaningful variables were selected, each of which were scored separately. The diagnostic value of the new scoring system was evaluated, and analyzed in comparison to the preexisting Alvarado score.
Results: Ten variables including vomiting, migration pain, fever, Dunphy’s sign, Rovsing’s sign, tenderness, rebound tenderness, increased white blood cell counts, increased neutrophil proportion, and increased CRP levels were associated with acute appendicitis. The new scoring system is developed by applying 1 point for each variable, with a total score of 10 points. In the new scoring system, a score above 5 points had sensitivity of 0.75, specificity of 0.73, positive predictive value of 0.92, and diagnostic accuracy of 0.71. The area under the receiver operating characteristic curve was 0.80, which is larger than 0.72 of the preexisting Alvarado score, and thus has a higher diagnostic accuracy. As acute appendicitis progresses, the average score tends to become significantly higher (P=0.001).
Conclusion: The new scoring system, which objectively reflects the clinical variables of the patient’s symptoms, physical examination and laboratory findings, will be useful in accurately diagnosing acute appendicitis and in quickly deciding a therapeutic policy in patients with right lower abdominal pain.

#Acute appendicitis #Right lower abdominal pain #Alvarado score

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