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Intraoperative Appendicitis Severity Score (IASS) of Kell et al

Description

Kell et al evaluated an intraoperative inflammation score used by the surgeon to describe the severity of appendicits seen during surgery. This can help to identify a patient who is more likely to have complications. The authors are from Cook University Hospital in Ireland.


 

Gross Appearance

Score

Degree

no gross evidence of inflammation (normal appearing)

0

none

thickened, engorged without serosal exudates or reaction

1

mild

thickened, engorged with serosal exudates

2

moderate

gangrene, perforation, and/or abscess

3

severe

 

where:

• An appendix may appear grossly normal yet show acute inflammation on histology. A code for the histologic appearance (A none, B minimal, C moderate, D gangrene or severe) might enhance the score.

• The authors mention that histology was not used since it was not available for several days. The pathology report should be available the next day in most cases.

 

Interpretation:

• The higher the score the greater the risk for sepsis and for surgical site infection.

 


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