Andersson and Andersson reported the Appendicitis Inflammatory Response Score for the diagnosis of acute appendicitis. The authors are from County Hospital Ryhov and University Hospital Linkoping in Sweden.
Patient selection: mean age 25.9 years for men and 23.4 years for women
Parameters:
(1) vomiting
(2) pain in right iliac fossa or right lower quadrant
(3) rebound tenderness or muscular defense
(4) body temperature in °C
(5) percent neutrophils in the differential count
(6) white blood cell count in 10^9/L
(7) serum CRP in mg/L
Parameter |
Finding |
Regression |
Simplified |
vomiting |
no |
0 |
0 |
|
yes |
0.45 |
1 |
pain in right iliac fossa |
no |
0 |
0 |
|
yes |
1.12 |
1 |
rebound tenderness or muscular defense |
none |
0 |
0 |
|
light |
1.54 |
1 |
|
medium |
1.90 |
2 |
|
strong |
2.32 |
3 |
body temperature |
< 38.5°C |
0 |
0 |
|
>= 38.5°C |
0.85 |
1 |
percent neutrophils |
< 70% |
0 |
0 |
|
70-44% |
0.92 |
1 |
|
>= 85% |
1.41 |
2 |
WBC count |
< 10 * 10^9/L |
0 |
0 |
|
10 to 14.9 |
0.96 |
1 |
|
>= 15 * 10^9/L |
1.46 |
2 |
CRP |
< 10 mg/L |
0 |
0 |
|
10 to 49 mg/L |
1.04 |
1 |
|
>= 50 mg/L |
2.35 |
2 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum scores based on regression model or simplified: 0
• maximum score for regression model: 9.96
• maximum score for simplified model: 12
Simplified Score |
Probability Appendicitis |
0 to 4 |
low |
5 to 8 |
intermediate |
9 to 12 |
high |
Performance:
• The area under the ROC curve 0.93.
Specialty: Gastroenterology