Comparison of diagnostic accuracy of the acute appendicitis inflammatory response score with the adult appendicitis score in Diagnosis of Acute Appendicitis

Abstract

Acute appendicitis (AA) is one of the most frequent surgical emergencies, yet identifying it clinically remains difficult, making it cumbersome for healthcare providers to reduce the rate of negative appendectomies. The objective of this study was to compare the diagnostic accuracy of the acute appendicitis inflammatory response (AIR) score with the adult appendicitis score (AAS) system considering the histopathological finding as gold standard. This Cross-sectional study was executed at the University Institute of Pubic Health, Faculty of Allied Health Sciences, the University of Lahore by taking data from department of General Surgery, Bahawalpur Victoria Hospital, Bahawalpur, from 5^th Feb, 2024 till 5^th Aug, 2024. The study included 109 patients who had a clinical suspicion of having acute appendicitis. The AAS and the AIR score were computed. Diagnostic assays were used to establish sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV). Receiver operating characteristic (ROC) curve was used to compare the areas under the curves of two scores. The mean age of the participants was 27.71 ± 8.67 years. AIR score had a slightly higher specificity (84.0%) and overall diagnostic accuracy (92.66%) than the AAS score. AAS score had a higher sensitivity (96.43%) and a better NPV (86.36%) than AIR. High diagnostic performance was shown by the ROC curve analysis. It revealed that the AIR score had an AUC of 0.912 (95% CI: 0.853-0.970) and the AAS score had an AUC of 0.936 (95% CI: 0.886-0.985). The AAS proved to be a slightly more effective tool for identifying AA compared to the AIR score. This indicates that AAS offers better diagnostic accuracy, which result in the reduction of unnecessary appendectomy rates.