卡拉曼评分：一种用于急性阑尾炎的新诊断评分

The Karaman score: A new diagnostic score for acute appendicitis.

作者信息

Karaman Kerem, Ercan Metin, Demir Hakan, Yalkın Ömer, Uzunoğlu Yener, Gündoğdu Kemal, Zengin İsmail, Aksoy Yakup Ersel, Bostancı Erdal Birol

机构信息

Department of General Surgery, Sakarya University Training and Research Hospital, Sakarya, Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2018 Nov;24(6):545-551. doi: 10.5505/tjtes.2018.62436.

DOI:10.5505/tjtes.2018.62436

PMID:30516254

Abstract

BACKGROUND

The Karaman score is a novel diagnostic scoring system consisting of 6 parameters. The aim of the present study was to assess the diagnostic performance of the Karaman score in comparison with the Alvarado score.

METHODS

A total of 200 patients who underwent an appendectomy were enrolled in the study (research registry number: 2290).

RESULTS

The cutoff threshold of the Karaman score in distinguishing acute appendicitis from negative appendectomy was ≥9 with 84.3% sensitivity, 64.7% specificity, 92.1% positive predictive value (PPV), and 45.8% negative predictive value (NPV). The cutoff threshold of the Alvarado score in distinguishing acute appendicitis from negative appendectomy was ≥8 with 72.9% sensitivity, 70.6% specificity, 92.4% PPV, and 34.8% NPV. In multivariate logistic regression analysis, an Alvarado ≥8 score (Odds ratio [OR]:6.644, 95% confidence interval [CI]: 2.854-15.466; p<0.001) and a Karaman ≥9 score (OR:10.374, 95% CI: 4.383-24.558; p<0.001) were each individually predictive in distinguishing acute appendicitis from negative appendectomy when correction was made according to age and gender. However, when both scores were evaluated together, the Alvarado score ≥8 lost its efficacy (OR:1.838, 95% CI: 0.517-6.530; p=0.347), whereas the Karaman score ≥9 retained its predictive power (OR:6.586, 95% CI: 1.893-22.917; p=0.003).

CONCLUSION

The Karaman score was more predictive than the Alvarado score in distinguishing acute appendicitis from a negative appendectomy.

摘要

背景

卡拉曼评分是一种由6个参数组成的新型诊断评分系统。本研究的目的是评估卡拉曼评分与阿尔瓦拉多评分相比的诊断性能。

方法

共有200例行阑尾切除术的患者纳入本研究（研究注册号：2290）。

结果

卡拉曼评分区分急性阑尾炎与阴性阑尾切除术的临界阈值为≥9，敏感性为84.3%，特异性为64.7%，阳性预测值（PPV）为92.1%，阴性预测值（NPV）为45.8%。阿尔瓦拉多评分区分急性阑尾炎与阴性阑尾切除术的临界阈值为≥8，敏感性为72.9%，特异性为70.6%，PPV为92.4%，NPV为34.8%。在多因素逻辑回归分析中，校正年龄和性别后，阿尔瓦拉多评分≥8（比值比[OR]：6.644，95%置信区间[CI]：2.854 - 15.466；p<0.001）和卡拉曼评分≥9（OR：10.374，95%CI：4.383 - 24.558；p<0.001）各自在区分急性阑尾炎与阴性阑尾切除术中具有单独的预测性。然而，当同时评估这两个评分时，阿尔瓦拉多评分≥8失去了其有效性（OR：1.838，95%CI：0.517 - 6.530；p = 0.347），而卡拉曼评分≥9保留了其预测能力（OR：6.586，95%CI：1.893 - 22.917；p = 0.003）。