Structured data collection improves the diagnosis of acute appendicitis

Kørner, Hartwig; Søndenaa, Karl; Søreide, Jon Arne; Andersen, E.; Nysted, Arne; Lende, Tone Hoel

doi:10.1046/j.1365-2168.1998.00627.x

Cited by 35 publications

(19 citation statements)

References 11 publications

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“…These reports reflect a more conservative attitude to the decision as to operate or not in patients with suspected acute appendicitis, resulting in a decreased appendectomy rate. A similar observation was previously reported [21]. However, this did not seem to influence the incidence of appendicitis during our study period.…”

Section: Discussionsupporting

confidence: 64%

Stability in Incidence of Acute Appendicitis

Kørner

Søreide²,

Pedersen

et al. 2001

Dig Surg

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Background/Aim of the Study: During the past 50 years, a decrease in incidence of appendicitis has been reported. The various studies were retrospective and based on different data sources. In the present study, we analyze prospectively the incidence of acute appendicitis during a 10-year period in a well defined population of 265,000. Methods: Prospective registration of all operations performed in patients with suspected acute appendicitis in the catchment area of a single institution. The diagnosis of acute appendicitis was based on histology in all cases. The annual incidence of acute appendicitis was calculated with regard to nonperforated and perforated acute appendicitis. Main Results: Between 1989 and 1998, 2,861 patients underwent surgery for suspected acute appendicitis. In 2,232 (78%) patients, acute appendicitis was confirmed histologically. Mean annual incidence was 84/100,000 (95% confidence interval 80 to 88/100,000). Crude incidence remained stable during the study period, with the exception of a significant increase in 1991 followed by a significant decrease the next year. Nonperforated acute appendicitis showed a different incidence pattern as compared to perforated acute appendicitis. Conclusion: In our prospective study, the incidence of acute appendicitis remained stable in our well-defined study population during the study period of 10 years. This is in contrast to the majority of studies during the last decades.

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Section: Discussionsupporting

confidence: 64%

Stability in Incidence of Acute Appendicitis

Kørner

Søreide²,

Pedersen

et al. 2001

Dig Surg

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“…Thus many centres today employ structured interview and examination forms to achieve the stated level of accuracy. In their recent paper, Korner et al (25) demonstrate how the use of structured data sheet improved preoperative diagnosis in their female population-a subgroup of patients in whom the diagnosis is known to be difficult. The role of leucocytosis in the diagnosis has remained controversial.…”

Section: Diagnosismentioning

confidence: 99%

Acute appendicitis: An overview

Saidi

Adwok²

2009

E Af Med Jrnl

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Objective: To provide an overview of the changing epidemiology of acute appendicitis in the developed and developing countries and the presumptive reasons. Data source: Major published series of the last two decades were reviewed using Medline Search and Index Medicus. The myriad of diagnostic approaches currently employed to reduce the hitherto high rates of negative appendicectomy were examined and current trends of management analysed. Conclusion:The treatment modalities of acute appendicitis have undergone tremendous changes in the last decade.

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“…Parte de la explicación a este fenómeno se encuentra en la heterogeneidad de los pacientes que se presentan en el grupo de probabilidad intermedia, por lo general, ancianos, inmunosuprimidos y mujeres en edad fértil (17,18). En especial, en este último grupo se ha reconocido que existe una tasa mayor de apendicectomías no terapéuticas (19)(20)(21)(22)(23), situación que ha motivado el uso rutinario de la ecografía y la tomografía abdominal (24,25) y de otros métodos diagnósticos, así como la recolección estructurada de datos (26). Esto sugiere que las mujeres en edad fértil y con hallazgos clínicos de dolor en la fosa ilíaca derecha, deben someterse a un período de observación más largo o a un escrutinio diagnóstico mucho más intenso, como se observa en el presente estudio.…”

Section: Discussionunclassified

Evaluación de escalas diagnósticas en pacientes con dolor abdominal sugestivo de apendicitis

et al. 2007

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Introducción. El diagnóstico de apendicitis es difícil y existen algunas escalas que pretenden mejorar la exactitud diagnóstica. Objetivo. Determinar las características operativas de las escalas de Alvarado y Fenyö, comparándolas con la impresión diagnóstica del cirujano y la patología en el dolor abdominal sugestivo de apendicitis. Materiales y métodos. Se trata de un estudio prospectivo de evaluación de pruebas diagnósticas. Se registraron los signos, síntomas y resultados de exámenes de laboratorio incluidos en las escalas. Se registró de manera ciega el diagnóstico del cirujano y su conducta. Se determinó la sensibilidad, especificidad, valores diagnósticos positivos y negativos, y likelihood ratio (índice de verosimilitud) de cada escala y del cirujano, discriminado por sexo. Resultados. Se analizaron 374 sujetos, sin diferencias estadísticamente significativas de variables entre sexos. Se operaron 269 pacientes. El 16,9% de los hombres y el 31,4% de las mujeres no tuvieron apendicitis. Para los hombres, la sensibilidad del diagnóstico por el cirujano fue mayor que las escalas (86,2% Vs. 73% en Alvarado Vs. 67,2% en Fenyö) con una especificidad similar. Para las mujeres la sensibilidad del cirujano y la escala de Alvarado fueron similares y superiores a la de Fenyö (77,1% Vs. 79,5% en Alvarado y 47% en Fenyö) pero la especificidad fue superior para Fenyö (92,9% Vs. 71,4% en Alvarado y 75,9% en cirujano). La frecuencia de apendicitis crece de manera proporcional al puntaje de Alvarado. Conclusión. Para hombres con dolor en la fosa iliaca derecha, el diagnóstico hecho por el cirujano es mejor que las escalas diagnósticas. Para el caso de las mujeres, la escala de Fenyö ofrece una mejor sensibilidad. La escala de Alvarado puede facilitar la conducta en pacientes con dolor en fosa iliaca derecha.Palabras clave: apendicitis/diagnóstico, escala creciente, sensibilidad y especificidad, dolor abdominal Evaluation of diagnostic scales for appendicitis in patients with lower abdominal pain Introduction. Diagnosis of apendicitis is difficult; however several clinical scales have been developed that attempt to improve diagnostic accuracy. Objective. The operational characteristics of Alvarado and Fenyö scales were defined in patients with abdominal pain suggestive of appendicitis and were compare with clinical and pathological diagnoses. Material and methods. A prospective trial assessed the diagnostic tests. Sign, symptoms, and laboratory tests were included in scales selected. Surgeon decision was maintained independent from the results of the scales. Sensitivity, specificity, positive and negative predictive value and positive and negative likelihood ratio for each scale was compared with the surgeon evaluation. Results. The sample included 374 patients with approximately equal sexes. Of these 269 patients underwent surgery. Howeve, 16.9% of the male and 31.4% of female patients did not have appendicitis. For men, a diagnosis made by the surgeon had better sensitivity than scales (86.2% vs. 73% for Alvarado and 67....

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Structured data collection improves the diagnosis of acute appendicitis

Cited by 35 publications

References 11 publications

Stability in Incidence of Acute Appendicitis

Stability in Incidence of Acute Appendicitis

Acute appendicitis: An overview

Evaluación de escalas diagnósticas en pacientes con dolor abdominal sugestivo de apendicitis

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