Appendicitis Inflammatory Response Score in Acute Appendicitis: A Study at a Tertiary Care Center in North India.

Abstract

Introduction: Appendicitis is a common cause of acute abdominal pain. The diagnosis is eminently clinical and the cause is surgically correctable. However, a decision of surgery based on the clinical presentation only has a 15%-30% chance of the removal of a normal appendix. Thus, the diagnosis involves a corroboration of clinical, laboratory, and radiological findings. Appendicitis scoring systems can be considered to expedite the diagnostic and decision-making process.

Aim: The present study was conducted to study the efficacy of Appendicitis Inflammatory Response (AIR) score in the diagnosis of acute appendicitis and its correlation with the histopathological findings.

Materials and methods: A cross-sectional study was conducted at a tertiary care center in North India comprising patients who presented to the surgery department with a provisional diagnosis of acute appendicitis and required appendectomy.

Results: Appendicitis was histopathologically proven in 54 patients. Patients with an AIR score ≥5 were 2.18 times more likely to have appendicitis. The probability of having appendicitis with AIR score ≥5 was 92.16% (positive predictive value). The diagnostic accuracy of AIR score was 82.81%.

Conclusion: AIR score has a high sensitivity and positive predictive value in the diagnosis of acute appendicitis. It is a quick and convenient system for clinical evaluation of patients in primary care or peripheral hospitals where advanced facilities such as USG scan or CT scan are not available all the time. The application of this scoring system definitely improves diagnostic accuracy and reduces negative appendectomy rate.