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.
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