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. 2013 Dec 21;19(47):9057-62.
doi: 10.3748/wjg.v19.i47.9057.

Alvarado, Eskelinen, Ohhmann and Raja Isteri Pengiran Anak Saleha Appendicitis scores for diagnosis of acute appendicitis

Hasan Erdem  1 , Süleyman Çetinkünar  1 , Koray Daş  1 , Enver Reyhan  1 , Cumhur Değer  1 , Mehmet Aziret  1 , Hilmi Bozkurt  1 , Selçuk Uzun  1 , Selim Sözen  1 , Oktay İrkörücü  1
Affiliations

Alvarado, Eskelinen, Ohhmann and Raja Isteri Pengiran Anak Saleha Appendicitis scores for diagnosis of acute appendicitis

Hasan Erdem et al. World J Gastroenterol. .

Abstract

Aim: To assess the reliability and practical applicability of the widely used Alvarado, Eskelinen, Ohhmann and Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring systems in patients with suspected acute appendicitis.

Methods: Patients admitted to our tertiary center due to suspected acute appendicitis constituted the study group. Patients were divided into two groups. appendicitis group (Group A) consisted of patients who underwent appendectomy and were histopathologically diagnosed with acute appendicitis, and non-appendicitis group (Group N-A) consisted of patients who underwent negative appendectomy and were diagnosed with pathologies other than appendicitis and patients that were followed non-operatively. The operative findings for the patients, the additional analyses from follow up of the patients and the results of those analyses were recorded using the follow-up forms.

Results: One hundred and thirteen patients with suspected acute appendicitis were included in the study. Of the 113 patients (62 males, 51 females), the mean age was 30.2 ± 10.1 (range 18-67) years. Of the 113 patients, 94 patients underwent surgery, while the rest were followed non-operatively. Of the 94 patients, 77 patients were histopathologically diagnosed with acute appendicitis. Our study showed a sensitivity level of 81% for the Alvarado system when a cut-off value of 6.5 was used, a sensitivity level of 83.1% for the Ohmann system when a cut-off value of 13.75 was used, a sensitivity level of 80.5% for the Eskelinen system when a cut-off value of 63.72 was used, and a sensitivity level of 83.1% for the RIPASA system when a cut-off value of 10.25 was used.

Conclusion: The Ohmann and RIPASA scoring systems had the highest specificity for the diagnosis of acute appendicitis.

Keywords: Acute appendicitis; Alvarado; Eskelinen; Ohhmann; Raja Isteri Pengiran Anak Saleha Appendicitis.

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Figures

Figure 1
Figure 1
If we use high cut-off values for diagnostic methods and accept where the majority (at least three methods) are positive as positive and the others as negative, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy values of this new diagnostic method would be 98.7%, 55.6%, 82.6%, 95.2% and 84.9%, respectively.
See this image and copyright information in PMC

References

    1. Christian F, Christian GP. A simple scoring system to reduce the negative appendicectomy rate. Ann R Coll Surg Engl. 1992;74:281–285. - PMC - PubMed
    1. Chong CF, Adi MI, Thien A, Suyoi A, Mackie AJ, Tin AS, Tripathi S, Jaman NH, Tan KK, Kok KY, et al. Development of the RIPASA score: a new appendicitis scoring system for the diagnosis of acute appendicitis. Singapore Med J. 2010;51:220–225. - PubMed
    1. Ohmann C, Yang Q, Franke C. Diagnostic scores for acute appendicitis. Abdominal Pain Study Group. Eur J Surg. 1995;161:273–281. - PubMed
    1. Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986;15:557–564. - PubMed
    1. Eskelinen M, Ikonen J, Lipponen P. Contributions of history-taking, physical examination, and computer assistance to diagnosis of acute small-bowel obstruction. A prospective study of 1333 patients with acute abdominal pain. Scand J Gastroenterol. 1994;29:715–721. - PubMed

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