Clinical scores for acute appendicitis in adults: A systematic review and meta-analysis of diagnostic accuracy studies.

IF 2.7 3区医学 Q1 SURGERY American journal of surgery Pub Date : 2025-02-01 Epub Date: 2024-12-05 DOI:10.1016/j.amjsurg.2024.116123

Luis Adrian Alvarez-Lozada, Bernardo Alfonso Fernandez-Reyes, Francisco Javier Arrambide-Garza, Mariana García-Leal, Neri Alejandro Alvarez-Villalobos, Javier Humberto Martínez-Garza, Bernardo Fernández-Rodarte, Rodrigo E Elizondo-Omaña, Alejandro Quiroga-Garza

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引用次数: 0

Abstract

Introduction: Early diagnosis of acute appendicitis is crucial to prevent complications. Numerous scores exist, but a comprehensive review comparing them is lacking. This systematic review aimed to compare all published clinical scoring systems for diagnosing acute appendicitis in adults.

Methods: A systematic review and meta-analysis 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 characteristics (SROC) were calculated.

Results: A total of 40 studies were included. The RIPASA score showed 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 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.

Conclusions: Our findings indicate that RIPASA is the most effective scoring system. Although the Alvarado score is the most studied, many other scores possess higher diagnostic accuracy.

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成人急性阑尾炎的临床评分：诊断准确性研究的系统回顾和荟萃分析。

早期诊断是预防急性阑尾炎并发症的关键。虽然有很多分数，但还没有对它们进行全面的比较。本系统综述旨在比较所有已发表的诊断成人急性阑尾炎的临床评分系统。方法：系统回顾和荟萃分析纳入了评估阑尾炎临床评分与组织病理学结果诊断准确性的研究。计算敏感性、特异性、诊断优势比（DOR）和总受试者工作特征（SROC）。结果：共纳入40项研究。RIPASA评分显示出更高的敏感性(0.93 [95% CI 0.78-0.98]；I2 = 96%),特异性(0.81 (95% CI 0.62 - -0.91);I2 = 86%)和金龟子(45.3 (95% CI 10.9 - -187.2);i2 = 89%)。RIPASA评分的SROC曲线AUC为0.913。结论：我们的研究结果表明，RIPASA是最有效的评分系统。虽然阿尔瓦拉多评分是研究最多的，但许多其他评分具有更高的诊断准确性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.