The evaluation of the validity of Alvarado, Eskelinen, Lintula and Ohmann scoring systems in diagnosing acute appendicitis in children

Abstract

Purpose: To show whether Alvarado, Eskelinen, Lintula and Ohmann scoring systems have predictive values in diagnosing acute appendicitis in children.

Methods: Sixty patients with suspected acute appendicitis were prospectively evaluated. Alvarado, Eskelinen, Lintula and Ohmann scores were calculated separately for each patient at the time of admission. The specificity, sensitivity, positive and negative predictive values of the scores were calculated. The predictive value of the scores was evaluated with the receiver operating characteristic (ROC) curve and the consistency among the scores by Kappa test.

Results: Twenty of the patients were female (33.3 %). The mean age of the patients was 9.9 years (3-16 years). Forty two patients were operated and appendectomies were performed with the diagnosis of acute appendicitis. The area under the ROC curve showed that the scores had no predictive value in diagnosing acute appendicitis. Kappa test showed that agreement between the scores was not good.

Conclusion: The sensitivity and specificity of the four scoring systems were not sufficient enough in diagnosing acute appendicitis in our patient group. We concluded that the most important factor affecting the decision for surgery in suspected acute appendicitis is the surgeon's experience combined with physical findings of repeated clinical examinations.