Published online Dec 21, 2013. doi: 10.3748/wjg.v19.i47.9057
Revised: September 9, 2013
Accepted: September 16, 2013
Published online: December 21, 2013
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.
Core tip: Several scoring systems have been devised to aid decision making in doubtful acute appendicitis cases, including the Ohmann, Alvarado, Eskelinen, Raja Isteri Pengiran Anak Saleha Appendicitis and several others. These scores utilize routine clinical and laboratory assessments and are simple to use in a variety of clinical settings. However, differences in sensitivities and specificities were observed if the scores were applied to various populations and clinical settings, usually with worse performance when applied outside the population in which they were originally created.