Sencan Arzu, Aksoy Nail, Yıldız Melih, Okur Özkan, Demircan Yusuf, Karaca Irfan
Department of Pediatric Surgery, Dr. Behçet Uz Children's Trianing Hospital, Izmir, Turkey,
Pediatr Surg Int. 2014 Mar;30(3):317-21. doi: 10.1007/s00383-014-3467-0.
To show whether Alvarado, Eskelinen, Lintula and Ohmann scoring systems have predictive values in diagnosing acute appendicitis in children.
Sixty patients with suspected acute appendicitis were prospectively evaluated. Alvarado, Eskelinen, Lintula and Ohmann scores were calculated separately for each patient at the time of admission. The specificity, sensitivity, positive and negative predictive values of the scores were calculated. The predictive value of the scores was evaluated with the receiver operating characteristic (ROC) curve and the consistency among the scores by Kappa test.
Twenty of the patients were female (33.3 %). The mean age of the patients was 9.9 years (3-16 years). Forty two patients were operated and appendectomies were performed with the diagnosis of acute appendicitis. The area under the ROC curve showed that the scores had no predictive value in diagnosing acute appendicitis. Kappa test showed that agreement between the scores was not good.
The sensitivity and specificity of the four scoring systems were not sufficient enough in diagnosing acute appendicitis in our patient group. We concluded that the most important factor affecting the decision for surgery in suspected acute appendicitis is the surgeon's experience combined with physical findings of repeated clinical examinations.
探讨阿尔瓦拉多、埃斯凯林、林图拉和奥曼评分系统在诊断儿童急性阑尾炎方面是否具有预测价值。
对60例疑似急性阑尾炎患者进行前瞻性评估。入院时分别计算每位患者的阿尔瓦拉多、埃斯凯林、林图拉和奥曼评分。计算各评分的特异性、敏感性、阳性预测值和阴性预测值。通过受试者工作特征（ROC）曲线评估评分的预测价值，并通过Kappa检验评估各评分之间的一致性。
20例患者为女性（33.3%）。患者的平均年龄为9.9岁（3 - 16岁）。42例患者接受手术，术中诊断为急性阑尾炎并行阑尾切除术。ROC曲线下面积显示，这些评分在诊断急性阑尾炎方面无预测价值。Kappa检验显示各评分之间的一致性不佳。
在我们的患者群体中，这四种评分系统在诊断急性阑尾炎时的敏感性和特异性不足。我们得出结论，影响疑似急性阑尾炎手术决策的最重要因素是外科医生的经验以及反复临床检查的体格检查结果。
