Validation of the Appendicitis Inflammatory Response (AIR) Score.
Validation of the Appendicitis Inflammatory Response (AIR) Score.
复制标题
DOI：
10.1007/s00268-021-06042-2
复制
发表时间：
2021-07
影响因子：
2.6
通讯作者：
Andersson RE
中科院分区：
文献类型：
--
作者：
Andersson M;Kolodziej B;Andersson RE
怀疑有阑尾炎的患者具有广泛的严重性。基于评分的风险分层可以优化对这些患者的管理。这项前瞻性研究验证了怀疑有阑尾炎的患者的阑尾炎炎症反应(AIR)评分。在瑞典医院的25个急诊科就诊的连续5岁以上的疑似阑尾炎患者被前瞻性纳入研究对象。对空气分数的诊断特性进行了估计。共纳入3878例患者，其中单纯阑尾炎821例，复杂性阑尾炎724例，非特异性腹痛1986例，其他诊断347例。在发现复杂性阑尾炎(ROC区0.89(95%可信区间0.88~0.90)比0.83(CI 0.82~0.84，p <； 0.001))、15岁以下患者和症状持续47小时的患者(ROC区0.93，CI 0.90~0.95，两类阑尾炎均为0.87，CI 0.84~0.90)方面得分更高。AIR评分>4分(阴性预测值99%，可信区间98~100%)不太可能并发阑尾炎。AIR评分和8分可能是阑尾炎，特别是年轻患者(阳性预测值(PPV)96%，CI 90-100%)和男性(PPV 89%，CI 84-93%)。AIR评分对复杂性阑尾炎有很高的敏感性，并能识别出并发阑尾炎概率低或阑尾炎概率高的亚组。儿童和症状持续时间长的患者的辨别能力较高。它在两性中的表现都一样好。这验证了AIR分数是否为有效的决策支持。试用注册号https://clinicaltrials.gov/ct2/show/NCT00971438
Patients with suspicion of appendicitis present with a wide range of severity. Score-based risk stratification can optimise the management of these patients. This prospective study validates the Appendicitis Inflammatory Response (AIR) score in patients with suspicion of appendicitis. Consecutive patients over the age of five with suspicion of appendicitis presenting at 25 Swedish hospital’s emergency departments were prospectively included. The diagnostic properties of the AIR score are estimated. Some 3878 patients were included, 821 with uncomplicated and 724 with complicated appendicitis, 1986 with non-specific abdominal pain and 347 with other diagnoses. The score performed better in detecting complicated appendicitis (ROC area 0.89 (95% confidence interval (CI) 0.88–0.90) versus 0.83 (CI 0.82–0.84) for any appendicitis, p < 0.001), in patients below age 15 years and in patients with >47 h duration of symptoms (ROC area 0.93, CI 0.90–0.95 for complicated and 0.87, CI 0.84–0.90 for any appendicitis in both categories). Complicated appendicitis is unlikely at AIR score <4 points (Negative Predictive Value 99%, CI 98–100%). Appendicitis is likely at AIR score >8 points, especially in young patients (positive predictive value (PPV) 96%, CI 90–100%) and men (PPV 89%, CI 84–93%). The AIR score has high sensitivity for complicated appendicitis and identifies subgroups with low probability of complicated appendicitis or high probability of appendicitis. The discriminating capacity is high in children and patients with long duration of symptoms. It performs equally well in both sexes. This verifies the AIR score as a valid decision support. Trial registration number https://clinicaltrials.gov/ct2/show/NCT00971438
登录
查看更多内容
流行病学和临床研究中缺少数据的多重归因：潜力和陷阱。
DOI：
10.1136/bmj.b2393
发表时间：
2009-06-29
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Sterne JA;White IR;Carlin JB;Spratt M;Royston P;Kenward MG;Wood AM;Carpenter JR
通讯作者：
Carpenter JR
影响因子：
9.6
作者：
Nepogodiev, D.;Matthews, J. H.;Bhangu, A.
通讯作者：
Bhangu, A.
影响因子：
3.8
作者：
Macco, Sven;Vrouenraets, Bart C.;de Castro, Steve M. M.
通讯作者：
de Castro, Steve M. M.
影响因子：
19.7
作者：
van Randen, Adrienne;Bipat, Shandra;Boermeester, Marja A.
通讯作者：
Boermeester, Marja A.
影响因子：
2.6
作者：
Andersson, Manne;Ruber, Marie;Andersson, Roland E.
通讯作者：
Andersson, Roland E.