A PRACTICAL SCORE FOR THE EARLY DIAGNOSIS OF ACUTE APPENDICITIS
A PRACTICAL SCORE FOR THE EARLY DIAGNOSIS OF ACUTE APPENDICITIS
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DOI：
10.1016/s0196-0644(86)80993-3
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发表时间：
1986-05-01
影响因子：
6.2
通讯作者：
ALVARADO, A
中科院分区：
文献类型：
--
作者：
ALVARADO, A
我们对305例因腹痛而住院的急性阑尾炎患者进行了回顾性研究。分析体征、症状和实验室结果的特异性、敏感性、预测值和联合概率。总联合概率，即真阳性和真阴性结果的总和，被选为指示测试准确性的诊断权重。发现8个预测因素对急性阑尾炎的诊断有用。根据其诊断权重，确定其重要性如下：右下象限局部压痛、白细胞增多、疼痛迁移、左移、体温升高、恶心-呕吐、厌食-丙酮、直接反跳痛。基于这个权重，我们设计了一个实用的诊断评分，可能有助于解释急性阑尾炎的混乱画面。
We conducted a retrospective study of 305 patients hospitalized with abdominal pain suggestive of acute appendicitis. Signs, symptoms, and laboratory findings were analyzed for specificity, sensitivity, predictive value, and joint probability. The total joint probability, the sum of a true-positive and a true-negative result, was chosen as a diagnostic weight indicative of the accuracy of the test. Eight predictive factors were found to be useful in making the diagnosis of acute appendicitis. Their importance, according to their diagnostic weight, was determined as follows: localized tenderness in the right lower quadrant, leukocytosis, migration of pain, shift to the left, temperature elevation, nausea-vomiting, anorexia-acetone, and direct rebound pain. Based on this weight, we devised a practical diagnostic score that may help in interpreting the confusing picture of acute appendicitis.