Augustin et al reported the ATMOS score for evaluating a pregnant woman for acute appendicitis. The authors are from University Hospital Centre Zagreb, IRSS ISMETT (Palermo) and University of Catania.
ATMOS is based on Appendicitis TriMOdal Score
Patient selection: pregnant woman
Parameters:
(1) anorexia
(2) pain migration to the right lower quadrant
(3) rebound pain
(4) maximum temperature in °C
(5) CRP to platelet ratio
(6) neutrophil to lymphocyte ratio (NLR)
(7) ultrasonographic signs of acute appendicitis
Parameter
Finding
Points
anorexia
no
0
yes
1
pain migration
no
0
yes
1
rebound pain
no
0
yes
1
temperature
<= 37.3°C
0
> 37.3°C
1
CRP to platelet ratio
<= 0.0422
0
> 0.0422
2
NLR
<= 7.182
0
> 7.182
2
ultrasound signs
no
0
yes
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• A score > 4 was associated with 94% of patients having acute appendicitis.
• A score <= 4 was associated with less than 13% having acute appendicitis.
Performance:
• The area under the ROC curve is 0.96.
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