Open AccessA Simplified Appendicitis Score in the Diagnosis of Acute Appendicitis
Author(s) -
Goh PL
Publication year - 2010
Publication title -
hong kong journal of emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.145
H-Index - 12
eISSN - 2309-5407
pISSN - 1024-9079
DOI - 10.1177/102490791001700305
Subject(s) - medicine , vomiting , alvarado score , nausea , appendicitis , anorexia , acute appendicitis , abdominal pain , appendix , tenderness , gastroenterology , surgery , paleontology , biology
Scoring systems such as the Modified Alvarado Score (MAS) can help in the early diagnosis of acute appendicitis (AA) but is cumbersome to use and has not found widespread popularity. A more robust, user‐friendly Simplified Appendicitis Score (SAS) was investigated. Methods Patients presenting with suspected AA were prospectively enrolled. The performance of the SAS (using only 5 variables – migratory pain, right lower quadrant tenderness, rebound pain, fever >37.3 degrees Celsius and leucocytosis >12,000/uL) was analysed and compared to the MAS. Results Out of 238 patients enrolled over four months, 95 (39.9%) patients underwent appendectomy, of which 81 patients had histologically proven AA. A MAS of ≥8 was 92.4% specific for ruling in AA, while a score of <5 was 91.4% sensitive in ruling out AA. A SAS of ≥6 was 91.7% specific for ruling in AA, while a score of <4 was 90.1% sensitive in ruling out AA. Conclusions The performance of the MAS can be maintained by omitting the two subjective variables – “anorexia” and “nausea/vomiting”, and increasing the leucocytosis cut‐off level. A SAS using only 5 variables performed as well as the original MAS.