Shabir预测复杂阑尾炎的“SMART-LAB”评分是一项前瞻性研究。

IF 0.5 Q4 SURGERY
Shabir Ahmad Mir, Mumtaz Din Wani
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引用次数: 0

摘要

目的:复杂性阑尾炎需要积极和紧急的治疗,因此需要一种有效的预测复杂性阑尾炎的评分系统。考虑到这一点,作者开发了目前预测复杂急性阑尾炎的评分系统。该研究旨在评估这种新颖的(Shabir’s SMART-LAB)评分在预测复杂阑尾炎诊断中的适用性。材料和方法:在这项前瞻性研究中,作者(Shabir)根据他之前的观察提出了一个新的评分,命名为“SMART-LAB”score,对所有患者进行计算。该评分包括超声(S)、右髂窝迁移性疼痛(M)、厌食(A)、反跳压痛(R)、压痛(T)、白细胞增多(L)、急性期蛋白- crp (A)、血清胆红素(B)。结果:本研究共纳入150例患者,术中/病理检查52例为穿孔和/或坏疽性阑尾炎。最常受影响的年龄组是10-19岁。复杂(穿孔、坏疽)阑尾炎患者SMART-LAB评分>9的人数明显高于非复杂阑尾炎患者(p值9,敏感性为80.7%,特异性为92.9%,PPV= 85.7%, NPV= 90.1%,准确性为88.7%),7-9分需进一步确认才能得出结论。这种新颖的评分(Shabir的SMART-LAB评分)似乎是预测复杂阑尾炎诊断的一个相当好的工具。阑尾穿孔的早期诊断对于限制相关的腹部败血症是重要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Shabir's "SMART-LAB" score for predicting complicated appendicitis-a prospective study.

Shabir's "SMART-LAB" score for predicting complicated appendicitis-a prospective study.

Shabir's "SMART-LAB" score for predicting complicated appendicitis-a prospective study.

Objectives: Complicated appendicitis needs an aggressive and urgent management, hence there is need of an efficient scoring system for predicting complicated appendicitis. With this in mind, the author developed the present scoring system for predicting complicated acute appendicitis. The study aimed to assess the suitability of this novel (Shabir's SMART-LAB) score for predicting diagnosis of complicated appendicitis.

Material and methods: In this prospective study, a novel score designated as "SMART-LAB" SCORE, proposed by the author (Shabir) based on his previous observations was calculated in all patients. This score includes sonography (S), migratory right iliac fossa pain (M), anorexia (A), rebound tenderness (R), tenderness (T), leukocytosis (L), Acute phase protein-CRP (A), and serum bilirubin (B).

Results: Of a total of 150 patients included in this study, 52 cases turned out to be perforated and/or gangrenous appendicitis on intraoperative/histopathologic examination. The most commonly affected age group was 10-19 years. SMART-LAB score of >9 was present in significantly higher number of patients in complicated (perforated and gangrenous) appendicitis than uncomplicated appendicitis (p value<0.001 i.e., highly significant). Hence, high likelihood of complicated appendicitis is reflected by a score >9 (with a sensitivity= 80.7%, specificity= 92.9%, PPV= 85.7%, NPV= 90.1%, and accuracy= 88.7%), while a score 7-9 needs further confirmation to reach a conclusion, and for a score of <7, there is low likelihood of complicated appendicitis.

Conclusion: It seems that this novel score (Shabir's SMART-LAB score) is a reasonably good tool to predict the diagnosis of complicated appendicitis. Early diagnosis of appendiceal perforation is important to limit the associated abdominal sepsis.

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