Can Alvarado and Appendicitis Inflammatory Response scores evaluate the severity of acute appendicitis? [Ulus Travma Acil Cerrahi Derg]
Ulus Travma Acil Cerrahi Derg. 2018; 24(6): 557-562 | DOI: 10.5505/tjtes.2018.72318  

Can Alvarado and Appendicitis Inflammatory Response scores evaluate the severity of acute appendicitis?

Metin Yeşiltaş, Dursun Özgür Karakaş, Berk Gökçek, Semih Hot, Seracettin Eğin
Department of General Surgery, Okmeydanı Training and Research Hospital, İstanbul-Turkey

BACKGROUND: The Alvarado score (AS) and the Appendicitis Inflammatory Response score (AIRS) were developed to diagnose acute appendicitis (AA). The aim of this study was to evaluate the severity of AA using the AS and the AIRS tools.
METHODS: Patients who presented between January 2016 and December 2017 and underwent surgery for AA and who had a preoperative AS and AIRS value were evaluated retrospectively. The details of age, sex, pathological severity, the presence of local peritonitis or fecaloid, drainage, appendix diameter, and operation type were evaluated according to the AS and the AIRS.
RESULTS: A total of 578 patients were included in the study. Appendicitis was the most common pathological severity classification (44.4%). The most common appendix diameter group was 7–10 mm (59.2%). The difference observed in the AS and AIRS results for all of the pathological severity categories was statistically significant (p<0.05). The AIRS revealed a statistically significant difference (p<0.05) in the detection of uncomplicated and complicated appendicitis. The AIRS difference was statistically significant for appendix diameter (p<0.05). The AS and the AIRS results were both statistically significant for drainage (p<0.05). The AS was correlated with pathological severity, local peritonitis, and drainage, while the AIRS was correlated with pathological severity, uncomplicated/complicated determination, appendix diameter, and drainage (p<0.05).
CONCLUSION: Both the AS and the AIRS can evaluate pathological severity, but only the AIRS can evaluate complicated or uncomplicated appendicitis and the diameter of the appendix. These tools can be used to reduce the number of unnecessary radiological or surgical interventions.

Keywords: Acute appendicitis, Alvarado score; Appendicitis Inflammatory Response score; drainage; local peritonitis; pathology


Alvarado ve Apandisit İnflamatuar Yanıt Skorlamaları Akut Apandisitin Şiddetini Değerlendirebilir mi?

Metin Yeşiltaş, Dursun Özgür Karakaş, Berk Gökçek, Semih Hot, Seracettin Eğin
Okmeydanı Eğitim Ve Araştırma Hastanesi, Genel Cerrahi Servisi, İstanbul, Türkiye

Giriş: Alvarado (AS) and Apandisit İnflamatuar Yanıt (AIYS) skorları akut apandisit (AA) tanısı için geliştirilmiş skorlardır. Bu çalışmanın amacı AA şiddetinin AS ve AIYS ile değerlendirmesidir.
Materyal ve Metot: Ocak 2016-Aralık 2017 tarihleri arasında AA nedeni ile opere edilen ve preop AS ve AIYS yapılan hastalar geriye dönük değerlendirildi. Yaş, cinsiyet, patolojik şiddet, lokal peritonit, fekaloid, drenaj, apendix çapı ve operasyon şekli AS ve AIYS göre değerlendirildi.
Bulgular: 578 hasta çalışmaya dâhil edildi. Apandisit %44,4 ile en sık görülen patolojiydi. En sık ölçülen apandiks çapı ise %59,2 ile 7-10 mm idi. Bütün patolojiler arasındaki AS ve AIYS istatistiksel olarak anlamlı bulundu (p<0,05). Komplike ve komplike olmayan apandisitler arasındaki sadece AIYS istatistiksel olarak anlamlı bulundu (p<0,05). Apandiks çapları arasındaki sadece AIYS istatistiksel olarak anlamlı bulundu (p<0,05). Drenaj yapılan hastalarda AS ve AIYS istatistiksel olarak anlamlı farklılık saptandı (p<0,05). AS ile patolojik şiddet, lokal peritonit ve drenajın korelasyonu, AIYS ile patolojik şiddet, komplike/ komplike olmayan, apandiks çapı ve drenajın korelasyonu istatistiksel olarak anlamlı bulundu (p<0,05).
Sonuç: AS ve AIYS her ikisi de patolojik şiddeti değerlendirebilmekte iken sadece AIYS komplike ve komplike olmayan apandisitleri, apandiks çapının daha anlamlı değerlendirebilmektedir. Bu skorları kullanarak gereksiz radyolojik ve cerrahi girişimlerini azaltabilecektir.

Anahtar Kelimeler: Akut apandisit, Alvarado Skoru, Apandisit İnflamatuar Yanıt Skoru, Patoloji, Drenaj, Lokal peritonit


Metin Yeşiltaş, Dursun Özgür Karakaş, Berk Gökçek, Semih Hot, Seracettin Eğin. Can Alvarado and Appendicitis Inflammatory Response scores evaluate the severity of acute appendicitis?. Ulus Travma Acil Cerrahi Derg. 2018; 24(6): 557-562

Corresponding Author: Dursun Özgür Karakaş, Türkiye


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