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The following is a summary of “Clinical Scores for Acute Appendicitis in Adults: A Systematic Review and Meta-analysis of Diagnostic Accuracy Studies,” published in the December 2024 issue of Surgery by Alvarez-Lozada et al.
Early diagnosis of acute appendicitis is critical for preventing complications. Numerous clinical scores exist, but a comparison of their diagnostic accuracy needs to be improved.
Researchers conducted a retrospective study to compare the diagnostic accuracy of clinical scores for diagnosing acute appendicitis.
They included studies assessing the diagnostic accuracy of clinical scores compared to histopathological findings for appendicitis. Sensitivities, specificities, diagnostic odds ratios (DOR), and summary receiver operating characteristic (SROC) curves were calculated.
The results showed the RIPASA score had superior sensitivity (0.93 [95% CI 0.78-0.98]; I2 =96%), specificity (0.81 [95% CI 0.62-0.91]; I2 =86%), and DOR (45.3 [95% CI 10.9-187.2]; I2 =89%). The area under the curve (AUC) for the SROC curve of the RIPASA score was 0.913. A significant difference was found between the RIPASA score and both the Alvarado score (P<0.002) and the Modified Alvarado score (P<0.004) in SROC curves.
They concluded that in adults, the RIPASA score was the most effective clinical score for diagnosing acute appendicitis.
Source: americanjournalofsurgery.com/article/S0002-9610(24)00675-5/abstract
