Ruptured Appendicitis Scoring System (RASS) of Williams et al

Description

Williams et al developed the Ruptured Appendicitis Scoring System (RASS) to evaluate children with acute appendicitis. The score can help the surgeon to make an accurate diagnosis of a ruptured appendix prior to surgery. The authors are from University of Tennessee, LeBonheur Children's Medical Center, University of South Carolina and the University of Arkansas.

Patient selection: child with acute appendicitis with age range 1 to 17 years

Parameters:

(1) generalized abdominal tenderness on physical exam

(2) duration of symptoms in hours

(3) abscess on CT scan

(4) fecalith on CT scan

(5) white blood cell count

Parameter	Finding	Points
generalized tenderness	absent	0
	present	4
duration of symptoms	<= 48 hours	0
	> 48 hours	3
abscess on CT scan	absent	0
	present	3
fecalith on CT scan	absent	0
	present	1
WBC count	<= 19,400 per µL	0
	> 19,400 per µL	2

total score =

= SUM(points for all 5 parameters)

Interpretation:

• minimum score: 0

• maximum score: 13

• The higher the score the more likely that the patient has a ruptured appendix.

Performance:

• The maximum Youden score is with a score >= 4.

• A score >= 7 has a specificity of 94% but a sensitivity of 68%.

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Ruptured Appendicitis Scoring System (RASS) of Williams et al

Description

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