Modified Clinical Score of Acute Appendicitis

Hussein Al - Taey, Ali

	Modified Clinical Score of Acute Appendicitis
Kerbala Journal of Medicine
Article 1, Volume 6, Issue 2, 2013, Pages 1615-1620 PDF (0 K)
Author
Ali Hussein Al - Taey
Abstract
background Suspected acute appendicitis is the most common non traumatic admissions to the surgical emergency units .Over past 100 years mortality and morbidity rates related to appendicitis have markedly decreased. The diagnosis of acute appendicitis is predominantly a clinical preoperatively but final diagnosis of acute appendicitis needs surgical reports per-operatively and the standard pathological examinations postoperatively .There are many clinical scores have been established to help in the diagnosis of the condition in surgical emergency room by junior surgeons in a short time in order to perform surgery in solid bases The main purposes of accurate diagnosis of acute appendicitis :- 1-Management of acute appendicitis in a short time and high accuracy to:- A-Avoid delayed diagnosis and prevent complications like perforation and finally peritonitis so mortality and morbidity of appendicitis markedly decrease B-Avoid missing of any cases . 2 -Avoid unnecessary surgery. Alvarado scoring system especially for junior residents who work as the primary receptors of surgical cases at surgical emergency units. Alvarado score system was identified as a useful clinical tool because it is readily available , extremely affordable ,and relatively accurate Aims This study: was conducted to modify Alvarado scoring system to more easy applicable, simple, cheap, quick and test( Reliability of suggested scoring system ) by which we avoided laboratory readings and technical errors that may cause diagnostic difficulties Patients and Methods a prospective study of 120 patients with suspected acute appendicitis admitted to surgical department -Al-Hussein teaching hospital—Karbala during the period from 1st January—to 31st December 2010 were included in this study. The patients were given specific scores according to this (Suggested score system) categorized into three categories Category 1 patients score 7 or more who underwent surgery Category 2 patients score 5—6 admitted for a surgical ward under observation Category 3 patients score 4 or less where acute appendicitis can be excluded. All appendices that removed surgically were sent for histopathological examination. Results By the (Suggested Score) Out of 120 patients 80 patients underwent surgery and acute appendicitis were confirmed in 60 patients thus negative appendectomy thus giving negative appendectomy frequency of 20%. Perforation rate was 6.25%.Positive Predictive Value was 80% (male 84% female 76%) Conclusion The (suggested scoring system) aids in the diagnosis of acute appendicitis. It helps junior residents in early diagnosis of acute appendicitis. It is quicker—simpler cheaper and easily applicable than Alvarado score in Iraq. The (Reliability of suggested scoring system) tested in this study and the result was that the new score had a good reliability compared to Alvarado scoring system
Keywords
acute appendicitis; clinical diagnosis scores; new scoring system

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