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右下腹疼痛患者中RIPASA评分系统和阿尔瓦拉多评分系统在急性阑尾炎诊断中的特异性和敏感性比较

Comparison between the specificity and sensitivity of the RIPASA and Alvarado Scoring systems in the diagnosis of acute appendicitis among patients with complaints of right iliac fossa.

作者信息

Dezfuli Seyed Ashkan Tabibzadeh, Yazdani Reza, Khorasani Mohammadjavad, Hosseinikhah Seyed Alireza

机构信息

Assistant Professor, Trauma and Emergency Medicine Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

Head of Department of Emergency Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

出版信息

AIMS Public Health. 2020 Jan 2;7(1):1-9. doi: 10.3934/publichealth.2020001. eCollection 2020.

Abstract

INTRODUCTION

Acute appendicitis is one of the common prevalent surgical emergencies. Various techniques, such as Alvarado Score are used for diagnosis it. This study was conducted to compare the Alvarado and RIPASA scoring systems in patients referred to Hospital with complaints of right iliac fossa pain.

METHODOLOGY

This descriptive-analytic cross-sectional study was conducted in patients over 15 years with abdominal pain referred to emergency room of the Hospital. The data collection form was completed for each patient based on history and examinations and then examined by a surgeon. The pathological specimens were examined and the pathological outcomes of each patient were recorded in the relevant information collection form and finally analyzed.

RESULTS

The results for the Alvarado system showed that 42.1%, 29.2% and 28.80% of the patients had a low probability, moderate probability and high probability of appendicitis, respectively. The findings for RIPASA system showed that 19.3% of patients definitely had appendicitis. The sensitivity and specificity of the Alvarado scoring system were 53.95% and 70.18%, respectively. Positive and negative predictive values of Alvarado were 70.69% and 53.33%, respectively. In contrast, the sensitivity, specificity, and positive and negative predictive values of the RIPASA scoring system were 93.42%, 45.61%, 69.61%, and 83.87%, respectively.

CONCLUSION

On the basis of the results, the RIPASA scoring system is a better system. Since the best cut-off point is 6 for Alvarado and 7.75 for RIPASA, it is better to use the values as a benchmark for the systems.

摘要

引言

急性阑尾炎是常见的外科急症之一。多种技术,如阿尔瓦拉多评分法,用于其诊断。本研究旨在比较阿尔瓦拉多评分系统和RIPASA评分系统在因右下腹疼痛转诊至我院的患者中的应用情况。

方法

本描述性分析横断面研究针对15岁以上因腹痛转诊至我院急诊科的患者进行。根据病史和检查为每位患者填写数据收集表,然后由外科医生进行检查。对病理标本进行检查,并将每位患者的病理结果记录在相关信息收集表中,最后进行分析。

结果

阿尔瓦拉多系统的结果显示,分别有42.1%、29.2%和28.80%的患者阑尾炎发生概率低、中、高。RIPASA系统的结果显示,19.3%的患者确诊为阑尾炎。阿尔瓦拉多评分系统的敏感性和特异性分别为53.95%和70.18%。阿尔瓦拉多的阳性预测值和阴性预测值分别为70.69%和53.33%。相比之下,RIPASA评分系统的敏感性、特异性、阳性预测值和阴性预测值分别为93.42%、45.61%、69.61%和83.87%。

结论

基于研究结果,RIPASA评分系统是更好的系统。由于阿尔瓦拉多评分系统的最佳截断值为6,RIPASA评分系统的最佳截断值为7.75,因此最好将这些值作为各系统的基准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1165/7109537/642d53f63421/publichealth-07-01-001-g001.jpg

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