Gupta Varun, Gupta Palak, Gill Chiranjiv Singh, Gupta Manvi
Department of Surgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Int J Appl Basic Med Res. 2022 Oct-Dec;12(4):234-238. doi: 10.4103/ijabmr.ijabmr_287_22. Epub 2022 Dec 19.
Appendicitis is a common cause of acute abdominal pain. The diagnosis is eminently clinical and the cause is surgically correctable. However, a decision of surgery based on the clinical presentation only has a 15%-30% chance of the removal of a normal appendix. Thus, the diagnosis involves a corroboration of clinical, laboratory, and radiological findings. Appendicitis scoring systems can be considered to expedite the diagnostic and decision-making process.
The present study was conducted to study the efficacy of Appendicitis Inflammatory Response (AIR) score in the diagnosis of acute appendicitis and its correlation with the histopathological findings.
A cross-sectional study was conducted at a tertiary care center in North India comprising patients who presented to the surgery department with a provisional diagnosis of acute appendicitis and required appendectomy.
Appendicitis was histopathologically proven in 54 patients. Patients with an AIR score ≥5 were 2.18 times more likely to have appendicitis. The probability of having appendicitis with AIR score ≥5 was 92.16% (positive predictive value). The diagnostic accuracy of AIR score was 82.81%.
AIR score has a high sensitivity and positive predictive value in the diagnosis of acute appendicitis. It is a quick and convenient system for clinical evaluation of patients in primary care or peripheral hospitals where advanced facilities such as USG scan or CT scan are not available all the time. The application of this scoring system definitely improves diagnostic accuracy and reduces negative appendectomy rate.
阑尾炎是急性腹痛的常见病因。诊断主要依靠临床症状，病因可通过手术纠正。然而，仅基于临床表现决定是否手术，切除正常阑尾的几率为15%-30%。因此，诊断需要综合临床、实验室及影像学检查结果。可考虑使用阑尾炎评分系统来加快诊断和决策过程。
本研究旨在探讨阑尾炎炎症反应（AIR）评分在急性阑尾炎诊断中的有效性及其与组织病理学结果的相关性。
在印度北部一家三级医疗中心进行了一项横断面研究，纳入对象为外科就诊且初步诊断为急性阑尾炎并需行阑尾切除术的患者。
54例患者经组织病理学证实为阑尾炎。AIR评分≥5的患者患阑尾炎的可能性高2.18倍。AIR评分≥5时患阑尾炎的概率为92.16%（阳性预测值）。AIR评分的诊断准确性为82.81%。
AIR评分在急性阑尾炎诊断中具有较高的敏感性和阳性预测值。对于基层医疗或周边医院中无法随时进行超声扫描或CT扫描等先进检查的患者，它是一种快速便捷的临床评估系统。该评分系统的应用确实提高了诊断准确性并降低了阴性阑尾切除率。
