A New Score Proposal for Diagnosing Acute Appendicitis in Adults

Abstract

Introduction: Acute appendicitis is one of the most common causes of acute surgical abdomen. Since it remains a diagnostic challenge, it has several diagnostic scales available.

Objective: To determine the superiority of a new resulting score versus the Alvarado score in the diagnosis of acute appendicitis.

Methods: A study of diagnostic tests was carried out using the database of the surgery service of the Regional Teaching Hospital of Trujillo, between February and December 2015. With the data collected, a new diagnostic score was elaborated and assessed with the histopathological report; and then, to assess its application, it was compared with the Alvarado score. Sensitivity, specificity and predictive values of both scores were calculated.

Results: 312 patients were included in the study, 177 were male (56.73%) and 135 were female (43.27%), with a mean age of 31 years (±11.3). A total of 267 (85.58%) patients had acute appendicitis confirmed by histopathological study. The new clinical score resulting from a logistic regression according to the Wald test was made up of four variables: male sex, vomiting, previous self-medication and Blumberg's sign. The results of the area under curve for the new clinical score and the Alvarado score were 0.711 and 0.707, respectively.

Conclusions: The new clinical score is better than the Alvarado score, according to the area under curve, but not by a significant value.