Ozkan Seda, Duman Ali, Durukan Polat, Yildirim Afra, Ozbakan Omer
Department of Emergency Medicine, Erciyes University Medical School, Kayseri, Turkey.
Niger J Clin Pract. 2014 Jul-Aug;17(4):413-8. doi: 10.4103/1119-3077.134001.
In this study, we aim to compare the relationship between the Alvarado score, ultrasonography, and multislice computerized tomography (CT) findings used for the diagnosis of the patients who presented to our emergency unit with clinical features suggestive of acute appendicitis.
Seventy-four patients operated with the diagnosis of acute appendicitis were included in the study. The demographic characteristics of the patients, physical findings, blood parameters, Alvarado scores, the radiological method used for the diagnosis, the surgical methods (open or laparoscopic) and the pathology results were recorded on the standard proforma. The collected data were analyzed with Statistical Package for Social Sciences (SPSS 15 for Windows, SPSS Inc., Chicago, Illinois, USA) computer program.
During study period, the sensitivity of ultrasonography was found to be as 71.2%, specificity as 46.7%, the positive predictive value (PPV) as 82.2%, the negative predictive value (NPV) as 31.8%, and the accuracy rate was determined as 65.7%. The sensitivity of tomography was determined as 97.2%, the specificity as 62.5%, PPV as 92.1%, and NPV as 83.3%, and the accuracy rate was determined as 90%. The sensitivity of the Alvarado score was calculated as 54%, the specificity as 73.3%, the PPV as 88.2% and the NPV as 29.7%, and the accuracy rate was determined as 57.7%.
In conclusion, computerized tomography (CT) was found to have higher specificity and sensitivity than Alvarado score and USG which are not sufficient on their own for taking the decision for surgery. We also found that CT scan had lower negative laparotomy rate when compared with the other two modalities.
在本研究中,我们旨在比较用于诊断以急性阑尾炎临床特征就诊于我院急诊科患者的阿尔瓦拉多评分、超声检查及多层螺旋计算机断层扫描(CT)结果之间的关系。
本研究纳入74例诊断为急性阑尾炎并接受手术的患者。患者的人口统计学特征、体格检查结果、血液参数、阿尔瓦拉多评分、用于诊断的放射学方法、手术方式(开放或腹腔镜)及病理结果均记录在标准表格上。收集的数据采用社会科学统计软件包(美国伊利诺伊州芝加哥市SPSS公司的Windows版SPSS 15)计算机程序进行分析。
在研究期间,超声检查的敏感性为71.2%,特异性为46.7%,阳性预测值(PPV)为82.2%,阴性预测值(NPV)为31.8%,准确率为65.7%。CT扫描的敏感性为97.2%,特异性为62.5%,PPV为92.1%,NPV为83.3%,准确率为90%。阿尔瓦拉多评分的敏感性计算为54%,特异性为73.3%,PPV为88.2%,NPV为29.7%,准确率为57.7%。
总之,发现计算机断层扫描(CT)比阿尔瓦拉多评分和超声检查具有更高的特异性和敏感性,后两者单独用于手术决策是不够的。我们还发现,与其他两种检查方式相比,CT扫描的阴性剖腹率更低。