Abstract
The role of clinical, laboratory, and imaging findings in the diagnosis of appendicitis: a retrospective analysis
- Emergency Department, General Hospital of Didymoteicho, Didymoteicho, Greece
- Department of Surgery, General Hospital of Eastern Achaia – Unit of Aigio, Aigio, Greece
- Department of Surgery, General University Hospital of Patras, Patras, Greece
- Department of Cardiothoracic and Vascular Surgery, WestpfalzKlinikum, 67655 Kaiserslautern, Germany
- Laboratory of Medical Statistics, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
- Department of Radiology, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
- Department of Radiology, General Hospital of Didymoteicho, Didymoteicho, Greece
- Department of Surgery, General Hospital of Didymoteicho, Didymoteicho, Greece
- Second Department of Surgery, Democritus University of Thrace, Medical School, Alexandroupolis, Greece
Introduction
Appendicitis represents a prevalent surgical emergency globally, posing a significant risk of severe complications. These complications encompass a spectrum of conditions, including ileus, peritonitis, abscess formation, and, in extreme cases, mortality.
Aim
The present study aims to assess the association of existing risk scores for the diagnosis of acute appendicitis and patient characteristics with the diagnosis of acute appendicitis, the odds of operative vs non-operative management, and postoperative outcomes.
Material and methods
In total, 109 patients assessed for acute appendicitis were included in this study.
Results
Sex (p = 0.99, OR = 1.01, 95% CI: 0.87–1.17) and age (p = 0.23, OR = 1.01, 95% CI: 0.98–1.04) were not found to be significantly associated with the diagnosis of appendicitis. Patients with radiating pain were significantly less likely to be diagnosed with appendicitis compared to those with localized pain (p = 4.05 × 10–6, RR = 0.0918, 95% CI: 0.039–0.217). The duration of symptoms did not significantly influence the diagnosis (p = 0.12, RR = 1.04, 95% CI: 0.98–1.11). Increased ALVARADO scores were significantly associated with operative treatment, with patients receiving an appendicectomy having a mean score of 7.56 (SD 1.91) and patients undergoing conservative management having a mean score of 4.92 (SD 1.56) (p-value < 0.001).
Conclusions
The results of this study highlight the importance of clinical presentation, physical examination findings, and specific laboratory markers in the diagnosis of appendicitis. While demographic factors and certain biomarkers did not show significant associations, the combination of clinical and laboratory data can aid in accurate diagnosis and timely intervention.
Keywords
clinical scoring systems, appendicitis, Alvarado score, RIPASA grading system, right lower quadrant (RLQ) pain
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