Comparison of the Appendicitis Inflammatory Response System and Alvarado Scores for the Prediction of the Acute Appendicitis
DOI:
https://doi.org/10.51253/pafmj.v74i6.8711Keywords:
Acute Appendicitis, Appendicitis Inflammatory Response Score, Alvarado score.Abstract
Objective: To evaluate the accuracy of Appendicitis Inflammatory Response system in comparison to that of the Alvarado score for the diagnosis of the acute appendicitis.
Study Design: Validation study.
Place and Duration of Study: Accident and Emergency Department of Combined Military Hospital Rawalpindi, Pakistan, from Aug 2021 to Jan 2022.
Methodology: A total of 150 patients who presented to accident and emergency department with complaints of pain in right iliac fossa and were diagnosed clinically by surgeons as cases of acute appendicitis were included. Appendicitis Inflammatory Response and Alvarado scores were calculated for all patients and diagnostic accuracy was compared for both scores taking the histopathology report as the gold standard.
Results: The study had 87(56.1%) males and 63(40.6%) females. Ninety-six (61.9%) individuals were below 40 years of age. Ninety-nine (63.9%) of the patients presented within 48 hours of onset of symptoms. The sensitivity, specificity, PPV, NPV and accuracy were calculated as 89.4%, 77.8%, 50%, 96.7% and 88% for Appendicitis Inflammatory Response scoring system and 74.2%, 77.8%, 29.2%, 96.1% and 74.6% for Alvarado score respectively.
Conclusion: The diagnostic accuracy of Appendicitis Inflammatory Response score was better as compared to Alvarado in diagnosis of acute appendicitis.
Downloads
References
Al Awayshih MM, Nofal MN, Yousef AJ. Evaluation of Alvarado score in diagnosing acute appendicitis. Pan African Med J 2019; 34(1).
Hashemi SA, Teshnizi SH, Vafaei F, Ganji A, Sadeghi MM, Mizani A, et al. Incidence of Enterobius vermicularis in acute appendicitis: A systematic review and meta-analysis. J Acute Dis 2020; 9(4): 152-156.
https://doi.org/10.4103/2221-6189.288592
Sulo SS, Al-Atrakchi HA. The modified alvarado score versus alvarado score in the diagnosis of acute appendicitis. Med J Babylon 2019; 16(3): 203-206.
https://doi.org/10.4103/mjbl.mjbl_48_19
Ramya E, Nagalekshmi G. Role of Alvarado Score in Diagnosing Acute Appendicitis: A Prospective Observational Study. Int J Sci Stud 2021; 8(10): 170-173.
Petroianu A. Diagnosis of acute appendicitis. Int J Surg 2012; 10(3): 115-119.
https://doi.org/10.1016/j.ijsu.2012.02.006
Farmer DL. Clinical practice guidelines for pediatric complicated appendicitis: the value in discipline. JAMA Surg 2016; 151(5): e160193.
https://doi.org/10.1001/jamasurg.2016.0193
Luiz P, Teixeira C, Petroianu A. Differences between inflamed and non inflamed appendices diagnosed as acute appendicitis. Ann Med Surg 2021; 62: 135–139.
https://doi.org/10.1016/j.amsu.2021.01.044
Ohle R, O'Reilly F, O'Brien KK, Fahey T, Dimitrov BD. The Alvarado score for predicting acute appendicitis: a systematic review. BMC Med 2011; 9(1): 1-3.
https://doi.org/10.1186/1741-7015-9-139
Alvarado, A. Improved Alvarado Score (MANTRELS) for the early diagnosis of acute appendicitis. Int J Surg Res Pract 2019; 6(1): 1-6.
https://doi.org/10.23937/2378-3397/1410098
Chisthi MM, Surendran A, Narayanan JT. RIPASA and air scoring systems are superior to alvarado scoring in acute appendicitis: Diagnostic accuracy study. Ann Med Surg 2020; 59: 138-142.
https://doi.org/10.1016/j.amsu.2020.09.029
Karami MY, Niakan H, Zadebagheri N, Mardani P, Shayan Z, Deilami I. Which one is better? Comparison of the acute inflammatory response, Raja Isteri Pengiran Anak Saleha Appendicitis and Alvarado scoring systems. Ann Coloproctol 2017; 33(6): 227. https://doi.org/10.3393/ac.2017.33.6.227
Von-Muehlen B, Franzon O, Beduschi MG, Kruel N, Lupselo D. AIR score assessment for acute appendicitis. ABCD-Arq Bras Cir Di 2015; 28(3): 171-173.
https://doi.org/10.1590/S0102-67202015000300006
Pogorelić Z, Mihanović J, Ninčević S, Lukšić B, Elezović S, Polašek O, et al. Validity of Appendicitis Inflammatory Response Score in Distinguishing Perforated from Non-Perforated Appendicitis in Children. Children 2021; 8(4): 309.
http://dx.doi.org/10.3390/children8040309
Malik AM, Rasheed G, Mazhar T, Malik S, Asif M, Hafeez A, et al. Histopathological analysis of appendectomy specimens in a tertiary care hospital; a descriptive study. Professional Med J 2020; 27(8): 1570-1574.
https://doi.org/10.29309/TPMJ/2020.27.08.4189
Majid M, Maqsood R, Ali M, Malhi MAA, Hussain Z, Abbasi MH, et al. Comparison of Alvarado Score and RIPASA Score in the Accurate Diagnosis of Acute Appendicitis in Combined Military Hospital Rawalpindi. Pak Armed Forces Med J 2021; 71(5): 1519-1523. https://doi.org/10.51253/pafmj.v71i5.3596
Goyal MK, Chamberlain JM, Webb M, Grundmeier RW, Johnson TJ, Lorch SA, et al. Racial and ethnic disparities in the delayed diagnosis of appendicitis among children. Acad Emerg Med 2021; 28(9): 949-956. https://doi.org/10.1111/acem.14142
Mantoglu B, Gonullu E, Akdeniz Y, Yigit M, Firat N, Akin E, et al. Which appendicitis scoring system is most suitable for pregnant patients? A comparison of nine different systems. World J Emerg Surg 2020; 15(1): 1-8.
https://doi.org/10.1186/s13017-020-00310-7
Rud B, Vejborg TS, Rappeport ED, Reitsma JB, Wille-Jørgensen P. Computed tomography for diagnosis of acute appendicitis in adults. Cochrane Colorectal Group, editor. Cochrane Database Syst Rev [Internet]. 2019 Nov 19 [cited 2022 May 15] Available from: http://doi.wiley.com/10.1002/14651858.CD009977.pub2
Fu J, Zhou X, Chen L, Lu S. Abdominal Ultrasound and Its Diagnostic Accuracy in Diagnosing Acute Appendicitis: A Meta-Analysis. Front Surg 2021; 8: 707160.
https://doi.org/10.3389/fsurg.2021.707160
Bhangu A, RIFT Study Group on behalf of the West Midlands Research Collaborative. Evaluation of appendicitis risk prediction models in adults with suspected appendicitis: Identifying adults at low risk of appendicitis. Br J Surg 2020; 107(1): 73–86. https://doi.org/ 10.1002/bjs.11440
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Paras Ibn E Ali, Muhammad Ayub Ashraf Malhi, Nosheen Abbas Abbas, Ammara Iqbal Muhammad, Usman Bin Ali, Sohaib Ashraf
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
