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World Journal of Emergency Surgery
Published in: World Journal of Emergency Surgery 1/2017

Open Access 01-12-2017 | Research article

Performance of imaging studies in patients with suspected appendicitis after stratification with adult appendicitis score

Authors: Henna E. Sammalkorpi, Ari Leppäniemi, Eila Lantto, Panu Mentula

Published in: World Journal of Emergency Surgery | Issue 1/2017

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Abstract

Background

Diagnostic scoring is used to stratify patients with suspected appendicitis into three groups: high, intermediate, and low probability of appendicitis. The stratification can be used for selective imaging to avoid the harms of radiation without compromising diagnostic accuracy.
The aim was to study how stratification by Adult Appendicitis Score affects diagnostic performance of imaging studies.

Methods

Analysis of 822 patients who underwent diagnostic imaging for suspected appendicitis was made. Adult Appendicitis Score was used to stratify patients into groups of high, intermediate, and low probability of appendicitis. Diagnostic performance of computed tomography (CT) and ultrasound (US) was compared between these patient groups.

Results

After scoring, pre-test probability of appendicitis ranged from 9-16% in low probability group to 75-79% in high probability group in patients who underwent US or CT. Post-test probability of appendicitis after positive CT was 99, 91, and 75% in high probability, intermediate probability and low probability groups, respectively, p < 0.001. After positive US the respective probabilities were 95, 91 and 42%, p < 0.001.

Conclusion

Diagnostic imaging has limited value in patients with low probability of appendicitis according to Adult Appendicitis Score.
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Metadata
Title
Performance of imaging studies in patients with suspected appendicitis after stratification with adult appendicitis score
Authors
Henna E. Sammalkorpi
Ari Leppäniemi
Eila Lantto
Panu Mentula
Publication date
01-12-2017
Publisher
BioMed Central
Published in
World Journal of Emergency Surgery / Issue 1/2017
Electronic ISSN: 1749-7922
DOI
https://doi.org/10.1186/s13017-017-0119-4

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