A practical score for the early diagnosis of acute appendicitis

Annals of Emergency MedicinePublished 1 May 1986

Alfredo Alvarado

DOI10.1016/s0196-0644(86)80993-3

Source URL

Citations1,519

SJR quartileQ1

SJR score0.84

SNIP1.55

TL;DR

A practical diagnostic score is devised that may help in interpreting the confusing picture of acute appendicitis.

Abstract

We conducted a retrospective study of 305 patients hospitalized with abdominal pain suggestive of acute appendicitis. Signs, symptoms, and laboratory findings were analyzed for specificity, sensitivity, predictive value, and joint probability. The total joint probability, the sum of a true-positive and a true-negative result, was chosen as a diagnostic weight indicative of the accuracy of the test. Eight predictive factors were found to be useful in making the diagnosis of acute appendicitis. Their importance, according to their diagnostic weight, was determined as follows: localized tenderness in the right lower quadrant, leukocytosis, migration of pain, shift to the left, temperature elevation, nausea-vomiting, anorexia-acetone, and direct rebound pain. Based on this weight, we devised a practical diagnostic score that may help in interpreting the confusing picture of acute appendicitis.

Keywords

Decision SciencesMedicine

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54 Citations1988

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An analysis that compared hospitals by their individual ratios of normal appendices to perforations favors the conclusion that a small but real decrease in negative appendectomy rates could be achieved without producing more ruptures or perforation.

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29 Citations1977David Graham

A clinical scoring index, which accurately predicted the state of the appendix in 88% of patients, was constructed from the significant differences between the two groups, and was used in the differential diagnosis of abdominal pain.

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