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急性阑尾炎诊断量表的比较分析:阿尔瓦拉多量表、RIPASA量表和AIR量表

[Comparative analysis of diagnostic scales of acute appendicitis: Alvarado, RIPASA and AIR].

作者信息

Bolívar-Rodríguez Martín A, Osuna-Wong Benny A, Calderón-Alvarado Ana B, Matus-Rojas Jaime, Dehesa-López Edgar, Peraza-Garay Felipe de Jesús

机构信息

Departamento de Cirugía General. Centro de Investigación y Docencia en Ciencias de la Salud, Universidad Autónoma de Sinaloa, Culiacán, Sin. México.

Departamento de Estadística. Centro de Investigación y Docencia en Ciencias de la Salud, Universidad Autónoma de Sinaloa, Culiacán, Sin. México.

出版信息

Cir Cir. 2018;86(2):169-174. doi: 10.24875/CIRU.M18000029.

Abstract

INTRODUCTION

Acute appendicitis is the most common surgical disease in emergency surgery, however, it remains a diagnostic problem and represents a challenge despite the experience and the different clinical and paraclinical diagnostic methods.

OBJECTIVE

To evaluate in a comparative way the scale of Alvarado, AIR and RIPASA to determine which one is best as a diagnostic test of acute appendicitis in our population in order to arrive to an accurate diagnosis in the shortest possible time and cost.

METHOD

Observational, prospective, transversal and comparative study of 137 patients to whom the scale of Alvarado, AIR and RIPASA was applied, who entered the emergency service of the Civil Hospital of Culiacán (México) with abdominal pain syndrome suggestive of acute appendicitis.

RESULTS

The Alvarado scale presented sensitivity 97.2% and specificity of 27.6%. AIR presented sensitivity of 81.9% and specificity of 89.5%. RIPASA showed the same results as Alvarado. All tests showed diagnostic accuracy above 80.

CONCLUSIONS

Alvarado and RIPASA presented good sensitivity, however, AIR is more specific, and has better accuracy for the diagnosis of acute appendicitis, making a better screening and thus reducing unnecessary surgeries. Therefore, it is recommended to use more AIR than Alvarado and RIPASA.

摘要

引言

急性阑尾炎是急诊外科中最常见的外科疾病,然而,它仍然是一个诊断难题,尽管有经验以及各种临床和辅助临床诊断方法,但仍是一项挑战。

目的

以比较的方式评估阿尔瓦拉多(Alvarado)量表、AIR和RIPASA,以确定哪一种最适合作为我们人群中急性阑尾炎的诊断测试,以便在尽可能短的时间和成本内得出准确诊断。

方法

对137例患者进行观察性、前瞻性、横断面和比较性研究,这些患者因提示急性阑尾炎的腹痛综合征进入库利亚坎(墨西哥)市民医院急诊科,并应用了阿尔瓦拉多量表、AIR和RIPASA。

结果

阿尔瓦拉多量表的敏感性为97.2%,特异性为27.6%。AIR的敏感性为81.9%,特异性为89.5%。RIPASA的结果与阿尔瓦拉多量表相同。所有测试的诊断准确率均高于80。

结论

阿尔瓦拉多量表和RIPASA具有良好的敏感性,然而,AIR更具特异性,对急性阑尾炎的诊断具有更高的准确性,能更好地进行筛查,从而减少不必要的手术。因此,建议更多地使用AIR而非阿尔瓦拉多量表和RIPASA。

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