Diagnostic score in appendicitis - Validation of a diagnostic score (Eskelinen score) in patients in whom acute appendicitis is suspected
Diagnostic score in appendicitis - Validation of a diagnostic score (Eskelinen score) in patients in whom acute appendicitis is suspected
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DOI：
10.1007/s00423-003-0436-9
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发表时间：
2004-06-01
影响因子：
2.3
通讯作者：
Zielke, A
中科院分区：
文献类型：
--
作者：
Sitter, H;Hoffmann, S;Zielke, A
背景和目的。有时，急性阑尾炎的诊断可能很困难。然而，为了获得最低的发病率，早期准确的诊断至关重要。本研究旨在验证 Eskelinen 等人提出的评分系统。作为阑尾炎诊断的辅助手段。患者和方法。使用连续系列 2,359 名因怀疑阑尾炎而入院的患者的前瞻性记录数据进行验证。准确性和阳性预测值被定义为主要的整体性能参数，以及评估患者管理变化的不必要手术的比率。整体表现通过接收者-操作者特征（ROC）分析进行评估。结果。在 2,359 名患者中，662 名被证明患有急性阑尾炎（患病率为 28%）。评分的总体敏感性、特异性、阳性和阴性预测值以及准确度在截止值为 55 时分别为 0.79、0.85、0.68、0.91 和 0.835。将评分的截止值校准到 57 会产生更有利的结果（0.72、0.91、0.76、0.9 和 0.86）以及不必要的手术率从 26.6% 下降至 15.4%（P
Background and aim. At times, the diagnosis of acute appendicitis may be difficult. However, for minimum morbidity to be obtained, early and accurate diagnosis is essential. This study aimed to validate a scoring system proposed by Eskelinen et al. as an aid in making the diagnosis of appendicitis. Patients and methods. The prospectively documented data of a consecutive series of 2,359 patients admitted for suspicion of appendicitis were used for validation. Accuracy and positive predictive value were defined as the main overall performance parameters, as was the rate of unnecessary operations to assess changes of patient management. Overall performance was assessed by receiver-operator characteristics (ROC) analysis. Results. Of 2,359 patients, 662 were proven to have acute appendicitis (prevalence of 28%). The overall sensitivity, specificity, positive and negative predictive value, and accuracy of the score were 0.79, 0.85, 0.68, 0.91 and 0.835 at a cut-off value of 55. Calibration of the score's cut-off value to 57 yielded more favourable results (0.72, 0.91, 0.76, 0.9 and 0.86), and the rate of unnecessary operations declined from 26.6% to 15.4% (P