Department of Colorectal Surgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
Department of General Surgery, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
J Med Life. 2022 Apr;15(4):443-447. doi: 10.25122/jml-2021-0049.
Appendectomy is still the best treatment for acute appendicitis in pediatric patients. Given the problems of early and immediate diagnosis of acute appendicitis, defining the best diagnostic protocol for this condition is of utmost importance. Different diagnostic methods, such as Lintula and appendicitis inflammatory response (AIR) scoring systems, are used for this purpose. This study aims to compare Lintula and AIR scoring systems among children with suspicion of acute appendicitis regarding their postoperative outcomes. During two years, a prospective multicentric study was carried out in the selected hospitals of Iran. Pediatric patients admitted with the diagnosis of acute appendicitis were enrolled in the study. Before decision making, each patient's score was calculated according to two appendicitis scoring systems of Lintula and AIR. The clinical outcomes and diagnosis of patients were then compared to the results of each scoring system. For those patients who were a candidate to undergo surgery, the final diagnosis of acute appendicitis was made by histopathology. Patients were divided into high and low-risk groups according to scoring systems outcomes. Among the patients with lower scoring for appendicitis, the AIR scoring system had a sensitivity and specificity of 95%, which was more promising than that of the Lintula system (19%); however, the specificity was comparable between the two models (74% 83%). For patients at higher risk of acute appendicitis, although the AIR scoring systems did not provide reliable results (sen: 45% and spe: 25%), the Lintula scoring showed remarkable sensitivity (87%), accompanied by a high diagnostic accuracy (87%). AIR and Lintula scoring systems are not accurate models to predict the risk of acute appendicitis among children; therefore, they can serve as an adjacent modality for other diagnostic methods.
阑尾切除术仍然是小儿急性阑尾炎的最佳治疗方法。鉴于急性阑尾炎早期和即时诊断的问题，确定该疾病的最佳诊断方案至关重要。为此，采用了不同的诊断方法，如 Lintula 和阑尾炎炎症反应 (AIR) 评分系统。本研究旨在比较 Lintula 和 AIR 评分系统在疑似急性阑尾炎的儿童中的术后结果。在两年内，在伊朗选定的医院进行了前瞻性多中心研究。患有急性阑尾炎诊断的儿科患者被纳入研究。在做出决策之前，根据 Lintula 和 AIR 两种阑尾炎评分系统计算每位患者的评分。然后将患者的临床结果和诊断与每个评分系统的结果进行比较。对于那些适合手术的患者，通过组织病理学来确定急性阑尾炎的最终诊断。根据评分系统的结果将患者分为高风险和低风险组。在阑尾炎评分较低的患者中，AIR 评分系统的敏感性和特异性为 95%，比 Lintula 系统更有希望（19%）；然而，两种模型的特异性相当（74%和 83%）。对于急性阑尾炎风险较高的患者，尽管 AIR 评分系统提供的结果不可靠（敏感性：45%和特异性：25%），但 Lintula 评分表现出显著的敏感性（87%），同时具有较高的诊断准确性（87%）。AIR 和 Lintula 评分系统不是预测儿童急性阑尾炎风险的准确模型；因此，它们可以作为其他诊断方法的辅助手段。
