Jearwattanakanok Kijja, Yamada Sirikan, Suntornlimsiri Watcharin, Smuthtai Waratsuda, Patumanond Jayanton
Department of Surgery, Nakornping Hospital, Chiang Mai 50180, Thailand.
Division of Gastrointestinal Surgery and Endnoscopy, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Emerg Med Int. 2014;2014:320926. doi: 10.1155/2014/320926. Epub 2014 May 25.
Background. The differential diagnoses of acute appendicitis obstetrics, and gynecological conditions (OB-GYNc) or nonspecific abdominal pain in young adult females with lower abdominal pain are clinically challenging. The present study aimed to validate the recently developed clinical score for the diagnosis of acute lower abdominal pain in female of reproductive age. Method. Medical records of reproductive age women (15-50 years) who were admitted for acute lower abdominal pain were collected. Validation data were obtained from patients admitted during a different period from the development data. Result. There were 302 patients in the validation cohort. For appendicitis, the score had a sensitivity of 91.9%, a specificity of 79.0%, and a positive likelihood ratio of 4.39. The sensitivity, specificity, and positive likelihood ratio in diagnosis of OB-GYNc were 73.0%, 91.6%, and 8.73, respectively. The areas under the receiver operating curves (ROC), the positive likelihood ratios, for appendicitis and OB-GYNc in the validation data were not significantly different from the development data, implying similar performances. Conclusion. The clinical score developed for the diagnosis of acute lower abdominal pain in female of reproductive age may be applied to guide differential diagnoses in these patients.
背景。急性阑尾炎、妇产科疾病(OB - GYNc)或下腹部疼痛的年轻成年女性的非特异性腹痛的鉴别诊断在临床上具有挑战性。本研究旨在验证最近开发的用于诊断育龄女性急性下腹痛的临床评分。方法。收集因急性下腹痛入院的育龄妇女(15 - 50岁)的病历。验证数据来自于与开发数据不同时间段入院的患者。结果。验证队列中有302例患者。对于阑尾炎,该评分的敏感性为91.9%,特异性为79.0%,阳性似然比为4.39。诊断OB - GYNc的敏感性、特异性和阳性似然比分别为73.0%、91.6%和8.73。验证数据中阑尾炎和OB - GYNc的受试者工作特征曲线(ROC)下面积、阳性似然比与开发数据无显著差异,表明性能相似。结论。为诊断育龄女性急性下腹痛而开发的临床评分可用于指导这些患者的鉴别诊断。