Risk Stratification Using Appendicitis Inflammatory Response Score, A Useful Tool To Reduce Negative Appendicectomy Rate : Our Experience
Article
| IMSEAR
| ID: sea-185525
ABSTRACT
Background:
Acute appendicitis is mostly considered a clinical diagnosis and many surgeons resort to clinical judgement for deciding its management. Such cases often pose a diagnostic dilemma and result in significant negative exploration rates. Appendicitis Inflammatory Response (AIR) score, designed in 2008, is a validated clinical scoring system which has outperformed the well-known Alvarado scoring system. This study evaluates the risk stratification of patients as per AIR scores, correlation with the post-op histopathological examination (HPE) diagnosis to calculate the negative appendicectomy rate and to evaluate the diagnostic performance of this scoring system.Method:
This is a prospective observational study carried out between Nov 2016 and May 2018, on 150 cases of acute appendicitis that underwent surgical management.Result:
This study data revealed a negative appendicectomy rate of 9.33 %. Statistical analysis showed that scores of 9 - 12 has great accuracy for diagnosis, with a specificity of 100 % and positive predictive value of 1.0 whereas low scores of 0-4 potentially identify cases who do not require surgery.Conclusion:
The AIR score is an accurate diagnostic tool when a score of 9 is taken as cut-off. Management algorithms based on AIR score have the potential of reducing negative appendicectomy rate by correct identification of those who don't require surgery.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Type of study:
Etiology study
/
Observational study
/
Prognostic study
Year:
2019
Type:
Article
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