Objectives

To validate the Atema and APSI scoring systems in the diagnosis of complicated vs uncomplicated appendicitis. To compare these scoring systems with computed tomography (CT) imaging alone to establish which method provides most accurate prediction of complicated vs uncomplicated appendicitis.

Methods

This was a retrospective review of a sample of 160 patients that underwent appendicectomy and CT imaging for suspected appendicitis between 2018 and 2021 in a tertiary university teaching hospital. Each scoring system was applied to all patients and results analysed and compared with the effectiveness of CT imaging,

Results

32.5% (n = 52) were found to have complicated appendicitis and 67.5% (n = 108) uncomplicated appendicitis. Application of the Atema score to our cohort of patients resulted in a sensitivity 76.9% [CI (64.2, 87.5), specificity 58.7% [CI (48.9, 68.1)], PPV 47.1% [CI (40.5, 53.8) and NPV 84.2% [CI (76.0, 89.9)]. By comparison, the APSI yielded a sensitivity 50.9% [CI (36.6, 65.4)], specificity 76.1% [CI (67.0, 87.8)], PPV 50% [CI (39.2, 60.6)] and NPV 76% [CI (71.1, 81.7)]. Radiology prediction of complicated vs uncomplicated appendicitis with CT imaging showed sensitivity 46% [CI (32.2, 60.5)], specificity 79%; [CI (69.8, 86)], PPV 51% [CI (39.6, 62.5)] and NPV 75% [CI (69.8, 79.9)].

Conclusion

By comparing the APSI and Atema et al. scoring systems with CT reporting in our hospital, it appears that the Atema may confer some benefit in stratifying patient risk of complicated versus uncomplicated appendicitis. Further larger scale prospective studies are required.

中文翻译：

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两种新评分系统预测复杂性与单纯性阑尾炎的验证和比较

目标

验证 Atema 和 APSI 评分系统在诊断复杂性与简单性阑尾炎中的作用。将这些评分系统与单独的计算机断层扫描 (CT) 成像进行比较，以确定哪种方法可以最准确地预测复杂性与简单性阑尾炎。

方法

这是对 2018 年至 2021 年间在某三级大学教学医院因疑似阑尾炎接受阑尾切除术和 CT 成像的 160 名患者样本进行回顾性分析。每个评分系统均应用于所有患者，分析结果并与 CT 成像的有效性进行比较，

结果

32.5% (n = 52) 被发现患有复杂性阑尾炎，67.5% (n = 108) 患有非复杂性阑尾炎。将 Atema 评分应用于我们的患者队列，敏感性为 76.9% [CI (64.2, 87.5)，特异性为 58.7% [CI (48.9, 68.1)]，PPV 47.1% [CI (40.5, 53.8) 和 NPV 84.2% [CI（76.0，89.9）]。相比之下，APSI 的敏感性为 50.9% [CI (36.6, 65.4)]，特异性为 76.1% [CI (67.0, 87.8)]，PPV 50% [CI (39.2, 60.6)] 和 NPV 76% [CI (71.1)] ，81.7）]。通过 CT 成像对复杂性阑尾炎与简单性阑尾炎进行放射学预测的敏感性为 46% [CI (32.2, 60.5)]，特异性为 79%；[CI (69.8, 86)]、PPV 51% [CI (39.6, 62.5)] 和 NPV 75% [CI (69.8, 79.9)]。

结论

通过比较 APSI 和 Atema 等人。根据我们医院 CT 报告的评分系统，Atema 似乎可以在分层复杂性阑尾炎与简单性阑尾炎患者风险方面带来一些好处。需要进一步更大规模的前瞻性研究。