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儿童阑尾炎评分系统的比较

Comparison of Appendicitis Scoring Systems in Childhood Appendicitis.

作者信息

Sağ Sefa, Basar Dilek, Yurdadoğan Fatih, Pehlivan Yıldız, Elemen Levent

机构信息

Department of Pediatric Surgery, University of Health Sciences, Kanuni Training and Research Hospital, Trabzon, Turkey.

Department of Pediatric Surgery, University of Health Sciences, Sancaktepe Şehit Prof. İlhan Varank Training and Research Hospital, İstanbul, Turkey.

出版信息

Turk Arch Pediatr. 2022 Sep;57(5):532-537. doi: 10.5152/TurkArchPediatr.2022.22076.

Abstract

OBJECTIVE

Appendicitis scoring systems have been developed as a diagnostic tool to improve the decision-making process in patients with suspected appendicitis.The aim of the study was to compare the results of the Alvarado, The Pediatric Appendicitis Score, modified Pediatric Appendicitis Score, Lintula, and Tzanakis scoring systems in childhood appendicitis. We also aimed to see whether our rates of correct diagnosis and negative appendectomy could change, if we had made decisions using the scoring systems.

MATERIALS AND METHODS

The patients who underwent appendectomy because of suspected appendicitis between June 2019 and June 2020 were evaluated prospectively. The patients were divided into appendicitis and non-appendicitis groups according to histopathological findings. The obtained data were used to calculate the scores for the scoring systems and statistical analyses.

RESULTS

In the study, 141 patients were included. The negative appendectomy rate was 14.8%. The lowest negative appendectomy rate (6.38%) was obtained with the Lintula scoring system. Tzanakis scoring system had the highest accuracy rate (85.1%) compared to the other scoring systems.

CONCLUSION

The present scoring systems may assist in establishing the diagnosis of appendicitis and reducing negative appendectomy rates. The Lintula scoring system has the lowest negative appendectomy rate due to its higher specificity compared to Alvarado, Pediatric Appendicitis Score, modified Pediatric Appendicitis Score, and Tzanakis scoring systems. Tzanakis scoring system has the highest accuracy rate in the diagnosis of appendicitis, and thus we believe that it may be used as an alternative scoring system for children.

摘要

目的

阑尾炎评分系统已被开发作为一种诊断工具,以改善疑似阑尾炎患者的决策过程。本研究的目的是比较阿尔瓦拉多(Alvarado)、小儿阑尾炎评分、改良小儿阑尾炎评分、林图拉(Lintula)和察纳基斯(Tzanakis)评分系统在儿童阑尾炎中的应用结果。我们还旨在探讨如果使用评分系统进行决策,我们的正确诊断率和阴性阑尾切除率是否会发生变化。

材料与方法

对2019年6月至2020年6月期间因疑似阑尾炎接受阑尾切除术的患者进行前瞻性评估。根据组织病理学结果将患者分为阑尾炎组和非阑尾炎组。所获得的数据用于计算各评分系统的得分并进行统计分析。

结果

本研究共纳入141例患者。阴性阑尾切除率为14.8%。林图拉评分系统的阴性阑尾切除率最低(6.38%)。与其他评分系统相比,察纳基斯评分系统的准确率最高(85.1%)。

结论

目前的评分系统可能有助于阑尾炎的诊断并降低阴性阑尾切除率。与阿尔瓦拉多、小儿阑尾炎评分、改良小儿阑尾炎评分和察纳基斯评分系统相比,林图拉评分系统因其较高的特异性而具有最低的阴性阑尾切除率。察纳基斯评分系统在阑尾炎诊断中具有最高的准确率,因此我们认为它可作为儿童阑尾炎的替代评分系统。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/783e/9524470/5975267a02d1/tap-57-5-532_f001.jpg

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