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诊断评分在急性阑尾炎中的性别特异性表现。

Gender-specific Performance of a Diagnostic Score in Acute Appendicitis.

机构信息

Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland.

Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil.

出版信息

In Vivo. 2020 Nov-Dec;34(6):3687-3703. doi: 10.21873/invivo.12217.

Abstract

BACKGROUND/AIM: Although a negative appendectomy in female patients with acute abdominal pain (AAP) can be twice as frequent as in male patients, the accuracy of diagnostic scores (DSs) in acute appendicitis (AA) is rarely considered among patients with AAP. The aim was to study the gender-specific performance of a DS in AA.

PATIENTS AND METHODS

As an extension of the World Organisation of Gastro-Enterology Research Committee (OMGE) AAP study, 1,333 patients presenting with AAP were inclu ded in the study. The clinical history and diagnostic symptoms (n=22), signs (n=14) and laboratory tests (n=3) were recorded in each patient.

RESULTS

The most significant diagnostic predictors were used to construct DS formulas for AA diagnosis, separately for both genders. The formulas were tested at 6 different cut-off levels to find the best diagnostic performance for AA in females and males. The highest specificities of the DS [DS without leucocyte count (LC)] and DS (DS with LC) scores in detecting AA were 98% (95% CI=97-99%) and 98% (95% CI=96-99%), respectively. In the ROC comparison test, there was no statistically significant difference in the performance of DS and DS in female and male patients.

CONCLUSION

Our gender-specific DS reached very high AUC values for AA (0.948-0.956) in both genders, and there was no statistically significant difference in the AUC values of DS and DS between women and men with AAP.

摘要

背景/目的:尽管女性急性腹痛(AAP)患者的阴性阑尾切除术频率可能是男性患者的两倍,但在 AAP 患者中,很少考虑诊断评分(DS)在急性阑尾炎(AA)中的准确性。目的是研究 AA 中 DS 的性别特异性表现。

患者和方法

作为世界胃肠病学研究组织委员会(OMGE)AAP 研究的扩展,纳入了 1333 例 AAP 患者。每位患者记录了临床病史和诊断症状(n=22)、体征(n=14)和实验室检查(n=3)。

结果

使用最显著的诊断预测因素,分别为男女构建了用于 AA 诊断的 DS 公式。在 6 个不同的截断水平上测试了这些公式,以找到女性和男性 AA 的最佳诊断性能。DS[无白细胞计数(LC)的 DS]和 DS(有 LC 的 DS)评分检测 AA 的特异性最高,分别为 98%(95%CI=97-99%)和 98%(95%CI=96-99%)。在 ROC 比较检验中,DS 和 DS 在女性和男性 AAP 患者中的性能没有统计学上的显著差异。

结论

我们的性别特异性 DS 在男女两性中均达到了非常高的 AA(0.948-0.956)的 AUC 值,并且在 AAP 女性和男性中,DS 和 DS 的 AUC 值之间没有统计学上的显著差异。

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