Can the efficiency of modified Alvarado scoring system in the diagnosis acute appendicitis be increased with tenesmus?
Can the efficiency of modified Alvarado scoring system in the diagnosis acute appendicitis be increased with tenesmus?
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DOI：
10.1007/s00508-012-0308-9
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发表时间：
2013-01-01
影响因子：
2.6
通讯作者：
Coskun, Ali
中科院分区：
文献类型：
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作者：
Bulus, Hakan;Tas, Adnan;Coskun, Ali
急性阑尾炎是需要紧急手术干预的主要病理条件之一。最广泛接受的评分系统是改良的阿尔瓦拉多评分系统（MASS）。本研究旨在通过增加一个新的参数来提高MASS的效率，并评估其在急性阑尾炎诊断中的效率。除了MASS的标准，所有患者都被问及里急后重的存在。从敏感性、特异性、阳性预测值和阴性预测值等方面评价MASS和附加参数MASS的有效性，MASS、临床表现、超声检查和附加参数MASS诊断急性阑尾炎的准确率分别为64%、76%、85%和80%。临床表现、MASS和MASS加其他参数诊断急性阑尾炎的假阳性率分别为17%、26%和10%。临床表现诊断急性阑尾炎的敏感性和特异性分别为83%和66%。MASS诊断急性阑尾炎的敏感性和特异性分别为74%和39%，而MASS附加阑尾炎参数的敏感性和特异性分别提高到83%和66%，MASS是一种简单、廉价、客观的评分系统，不需要专业知识。在标准MASS中加入里急后重法，其诊断急性阑尾炎的准确率、敏感性和特异性均优于MASS。
Acute appendicitis is one of the main pathological conditions requiring emergency surgical intervention. The most widely accepted scoring system is modified Alvarado scoring system (MASS). In this study we aimed to improve the efficiency of MASS by adding a new parameter and to evaluate its efficiency in the diagnosis of acute appendicitis.This study included 158 patients who underwent acute appendectomy in Ke double dagger ioren Training and Research Hospital General Surgery Department. In addition to criteria of MASS, all patients were questioned about the presence of tenesmus. The validity of MASS and MASS with additional parameter was evaluated with respect to sensitivity, specificity and positive and negative predictive values.Accuracy rates of MASS, clinical findings, ultrasonography and MASS with additional parameter in the diagnosis of acute appendicitis were 64, 76, 85 and 80 %. False positivity rates for clinical findings, MASS and MASS with additional parameter in the diagnosis of acute appendicitis were 17, 26 and 10 %, respectively. Sensitivity and specificity of clinical findings in the diagnosis of acute appendicitis were 83 and 66 %, respectively. Sensitivity and specificity of MASS in the diagnosis of acute appendicitis were 74 and 39 %, respectively, and those of MASS with additional parameter were appendicitis increased to 83 and 66 %, respectively.MASS is a simple, cheap and objective scoring system and does not require expertise. When tenesmus is added to standard MASS, rates of accuracy, sensitivity and specificity become better than those in MASS in the diagnosis of acute appendicitis.