title: Scoring systems in the diagnosis of acute appendicitis in the elderly.
abstract: BACKGROUND
  Although special features of acute appendicitis in the elderly have been described in some studies, no studies evaluating the applicability of appendicitis scores exist in the literature. The aim of this study was to compare Alvarado and Lintula scores in patients older than 65 years of age.
  
  
  METHODS
  Patients older than 65 years with appendicitis confirmed by pathology report were matched by year of admission with a group of patients admitted to the emergency department with non-specific abdominal pain. Alvarado and Lintula scores were calculated retrospectively from patient charts.
  
  
  RESULTS
  Both scores were observed to operate well in distinguishing between abdominal pain due to appendicitis and non-specific abdominal pain. The Alvarado score was a better predictor compared to the Lintula score. Two parameters (absent, tingling or high-pitched bowel sounds and nausea) had similar prevalence in the control and appendicitis groups. We selected to recalculate the two scores with the exclusion of these two parameters. The two scores performed better but were more similar to each other after the modification.
  
  
  CONCLUSIONS
  Both Alvarado and Lintula scores have a high sensitivity and specificity in the diagnosis of acute appendicitis in the geriatric age group. Their performance improves with exclusion of the two parameters "nausea" and "absent, tingling or high-pitched bowel sounds".
authors.affiliation: Department of Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey. akonan@hacettepe.edu.tr
authors.forename: Ali
authors.initials: A
authors.lastname: Konan
authors.forename: Mutlu
authors.initials: M
authors.lastname: Hayran
authors.forename: Yusuf Alper
authors.initials: YA
authors.lastname: Kılıç
authors.forename: Derya
authors.initials: D
authors.lastname: Karakoç
authors.forename: Volkan
authors.initials: V
authors.lastname: Kaynaroğlu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014421:Turkey / Q000453:epidemiology