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Abdominal Pain Index for Diagnosis of Acute Appendictis

Purpose: To evaluate a patient with abdominal pain for appendicitis using the Abdominal Pain Index of Van Way et al.

Description

Van Way et al developed an Abdominal Pain Index to help identify patients with acute abdominal pain who have acute appendicitis. This is a discriminant score intended to be a computer-based aid for clinicians. The authors are from the University of Colorado in Denver.


 

Patient selection: Patients operated on for appendicits for a 5 year period.

 

Parameters:

(1) gender

(2) duration of symptoms

(3) nausea

(4) anorexia

 

Parameter

Finding

Points

gender

male

1

 

female

2

duration of symptoms

> 24 hours

1

 

<= 24 hours

2

nausea

yes

1

 

no

2

anorexia

yes

1

 

no

2

 

where:

• The waiting for gender reflects that women tend to have a greater number of causes for abdominal pain than men.

 

abdominal pain index =

= (4 * (points for sex)) + (5 * (points for duration)) + (5 * (points for nausea)) + (4 * (points for anorexia))

 

Interpretation:

• minimum score: 18

• maximum score: 36

• A score < 28 indicated appendicitis.

• A score > 28 indicated not appendicitis.

• I assume a score of 28 is indeterminate for appendicitis.

 

Limitations:

• The sensitivity was 82% while the specificity was 39%, which is pretty awful performance.

 


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Specialty

Objective

ICD-10