Which one in the diagnosis of acute appendicitis: Physical examination, laboratory or imaging? A retrospective analysis in the light of pathological results

Özdemi̇r, Hakan; Özdemir, Zehra Ünal; Sunamak, Oğuzhan; Cambaztepe, Ferdi

doi:10.29333/ejgm/81764

Cited by 5 publications

(11 citation statements)

References 13 publications

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“…Although numerous scoring systems have been defined, the diagnosis of acute appendicitis is not easily made in this condition. In fact, false positive results are still reported in 15–30% of cases [ 1 ].…”

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confidence: 99%

A comparative study on the diagnostic validity of three scoring systems in the diagnosis of acute appendicitis in emergency centres

Farahbakhsh

Torabi

Mirzaee

2020

African Journal of Emergency Medicine

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Background Considering the inconsistencies on the validity scoring systems in the diagnosis of acute appendicitis, our aim was to compare the accuracy of the three Anderson, Alvarado and Alvarado + CRP scoring systems in the diagnosis of patients with suspected acute appendicitis. Methods This was a prospective observational study performed on patients 15–65 years complained of abdominal pain in the RLQ with a high clinical suspicion of acute appendicitis within two years. The scoring systems of Anderson, Alvarado, and Alvarado + CRP were recorded using a pre-prepared questionnaire by a senior emergency medicine assistant. Acute appendicitis was confirmed based on the histopathologic findings. Written informed consent was obtained from all the patients before entering the study. Results 200 patients were enrolled in the study. In 159 cases diagnosed with appendicitis based on histopathological findings, Anderson, Alvarado, and Alvarado scoring systems were able to identify 121, 152, and 147 cases respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 77%, 19%, 78%, 17 and 64% in Anderson, 95%, 7%, 75%, 30% and 77% in Alvarado, and 92%, 7%, 79%, 20%, and 75% in Alvarado + CRP scoring systems, respectively. Conclusion Anderson scoring system had lower diagnostic accuracy than the Alvarado system. The role of CRP as an adjunct test to increase the accuracy of the Alvarado scoring system in the diagnosis of acute appendicitis has been under question. Given the inconsistent results of the scoring systems in the diagnosis of acute appendicitis, there is a need to develop a more precise clinical-paraclinical scoring system for this condition.

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Section: Introductionmentioning

confidence: 99%

A comparative study on the diagnostic validity of three scoring systems in the diagnosis of acute appendicitis in emergency centres

Farahbakhsh

Torabi

Mirzaee

2020

African Journal of Emergency Medicine

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“…For this reason, cases of acute appendicitis should be operated before the development of the complications. 1…”

Section: Introductionmentioning

confidence: 99%

Comparison of the reliability of scoring systems in the light of histopathological results in the diagnosis of acute appendicitis

Özdemir

Özdemi̇r

Sunamak

et al. 2018

Hong Kong Journal of Emergency Medicine

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Background: Acute appendicitis is a very common surgical emergency. Early and correct diagnosis and early intervention are necessary to prevent complications. It is often diagnosed on clinical signs and a certain ratio of negative appendectomy is acceptable. For early and accurate diagnosis, various scoring systems such as Alvarado, Ohmann, Eskelinen and more recently Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) have been developed. Objective: In this study, we aimed to compare the effectiveness and accuracy of scoring systems. Materials and methods: The patients who attended emergency department and operated with acute appendicitis pre-diagnosis were evaluated retrospectively. Alvarado, Ohmann, Eskelinen, and RIPASA scores were calculated and compared with histopathologic results by reviewing the patient files. Results: A total of 76 patients (44 males and 32 females) were included in the study. The mean age was 33.8 ± 13.2 years. Of which, 59 patients (77.6%) were diagnosed to have acute appendicitis on histopathological examination. The mean leukocyte count was 13.9 ± 3.7 × 103 μL. Sensitivity and specificity of Alvarado, Ohmann, Eskelinen, and RIPASA were 36%–82%; 58%–71%; 36%–8%, and 68%–71%, respectively. Cut-off values were 8, 14, 55.63, and 10, respectively. RIPASA had the highest accuracy. The cut-off value of leukocyte counts was 13,900 × 103/μL. Sensitivity and specificity were 64% and 88%, respectively; positive predictive value was 95%. In the receiver operating curve analysis, the area under the curve was found to be 74%. Conclusion: The RIPASA scoring system is a more reliable scoring system than Ohmann, Eskelinen, and Alvarado scoring systems. In cases of suspected acute appendicitis, it may be useful to evaluate patients with RIPASA score in emergency departments by general practitioners, where there is no general surgeon. Thus, patients can be guided in a timely manner to reduce the complications that may arise from delays. The cut-off value of 13,900 × 103/μL is an important marker for the presence of acute appendicitis.

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“…;Merzon & Vinogradov, 2015;Muravieva, 2008;Özdemir et al, 2018), when the growing needs of mankind began to contradict the deterioration of the quality of natural environment.To identify the components of the graduate's ecological culture, capable of becoming the elements of his meta-qualification, it is necessary to analyze its structure. This is also required by the pedagogical category "formation", considered as a process of conscious management by the development of a person or certain aspects of his personality, qualities, properties, and bringing them to a planned form(Savina, 2015).…”

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confidence: 99%

Strengthening the Practical Component in the Environmental Training of Future Engineers

Maslennikova¹,

Gibadulina²

2019

RPE

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Of the goal of study is to investigate the formation of such skills of strengthening of practical component of environmental training of students, having technical specialization. It is achieved by the introduction of such forms and methods of training,as the research of technical projects and scientific articles in the subjected area (using the method of diversionary analysis), the participation of students in the work of scientific departments at the enterprises, in eco-oriented production practice and in the interdisciplinary designing. The results of the experiment show a positive dynamics in the changes of formedness levels of the main characteristics of the students' ecological culture, and confirm the effectiveness of introduction the considered.

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Which one in the diagnosis of acute appendicitis: Physical examination, laboratory or imaging? A retrospective analysis in the light of pathological results

Cited by 5 publications

References 13 publications

A comparative study on the diagnostic validity of three scoring systems in the diagnosis of acute appendicitis in emergency centres

A comparative study on the diagnostic validity of three scoring systems in the diagnosis of acute appendicitis in emergency centres

Comparison of the reliability of scoring systems in the light of histopathological results in the diagnosis of acute appendicitis

Strengthening the Practical Component in the Environmental Training of Future Engineers

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