Evaluación de la Escala de Alvarado versus Score de Respuesta Inflamatoria de la Apendicitis, Hospital José Carrasco Arteaga 2018

Jorge Roberto Rodas Andrade, Marco Vinicio Urgilés Rivas, Julio Cesar Ordoñez Cumbe, Karla Marisela Cabrera Abad, Patricia Piedad Naulaguari Medina
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引用次数: 1

Abstract

BACKGROUND: Acute appendicitis is the main cause of non-traumatic acute abdomen worldwide, it is still a public health issue and the diagnosis can be challenging. When an atypical case is presented, is necessary to use diagnostic scores, like Alvarado Score, Modified Alvarado Score, RIPASA, among others. The aim of this study was to determine the test validity of Inflammatory Response Score versus Alvarado Score, for acute appendicitis diagnosis in 16 year old and older patients. METHODS: This is a descriptive, cross-sectional, validity test study, to compare AIR Score and Alvarado Score, with the Gold-Standard histopathology results. A sample of 292 patients that went under appendectomy at Hospital José Carrasco Arteaga during 2018 was studied. We considered sensitivity, specificity, positive predictive value (PPV), negative predictive value (VPN), ROC curve and Likelihood Ratio. RESULTS: 49.7% patients were young adults, 62.7% of the patients were male. Alvarado Score showed a 88.5% sensitivity, 29.6% specificity, PPV of 81.7%, 42.2% NPV, 1.23 LR+ and 0.38 –LR; compared to 94.7% sensitivity, 76.5% specificity, 93.5% PPV, 80.3% NPV, 4.02 +LR, 0.611 -LR for Appendicitis Immflamatory Response Score. ROC curve for AIRS was 0.897, higher than Alvarado Score (0.611); being AIRS a more precise diagnostic test than Alvarado Score. CONCLUSIÓN: AIRS showed higher sensitivity (94.7%) and specificity (76.5%) than Alvarado Score (88.5%, 29.6% respectively). Alvarado Score is sensitive enough for acute appendicitis diagnosis, but not specific enough to exclude the diagnosis. AIRS shows a higher Likelihood Ratio and ROC curve than Alvarado Score, but the posttest probability is low for identifying acute appendicitis cases.
Alvarado量表与阑尾炎炎症反应评分的评估,jose Carrasco Arteaga医院2018
背景:急性阑尾炎是世界范围内非外伤性急腹症的主要原因,它仍然是一个公共卫生问题,诊断可能具有挑战性。当出现非典型病例时,有必要使用诊断评分,如Alvarado评分、修改Alvarado评分、RIPASA等。本研究的目的是确定炎症反应评分与阿尔瓦拉多评分在16岁及以上患者急性阑尾炎诊断中的测试有效性。方法:这是一项描述性、横断面、效度检验研究,将AIR评分和Alvarado评分与金标准组织病理学结果进行比较。研究了2018年在josjoresco Arteaga医院接受阑尾切除术的292名患者的样本。我们考虑敏感性、特异性、阳性预测值(PPV)、阴性预测值(VPN)、ROC曲线和似然比。结果:青壮年占49.7%,男性占62.7%。Alvarado评分的敏感性为88.5%,特异性为29.6%,PPV为81.7%,NPV为42.2%,LR+ 1.23, -LR 0.38;阑尾炎炎症反应评分的敏感性为94.7%,特异性为76.5%,PPV为93.5%,NPV为80.3%,4.02 +LR, 0.611 -LR。AIRS的ROC曲线为0.897,高于Alvarado评分(0.611);是一个比阿尔瓦拉多评分更精确的诊断测试。CONCLUSIÓN: AIRS的敏感性(94.7%)和特异性(76.5%)高于Alvarado评分(88.5%)和29.6%。Alvarado评分对急性阑尾炎的诊断足够敏感,但不够特异性,不能排除诊断。AIRS的似然比和ROC曲线均高于Alvarado评分,但对急性阑尾炎的后验概率较低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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