title: The Value of Scoring Systems for the Diagnosis of Acute Appendicitis.
abstract: Accurate diagnosis of acute appendicitis (AA) is still a problem and is not always easy, even for experienced surgeons. Studies have shown that 20 to 30% of the appendices removedwere normal. Therefore, various scoring systems have been developed to aid in the diagnosis of doubtful cases and reduce the number of unnecessary appendectomies. The aim of this study was to assess the diagnostic value of different scoring systems in acute appendicitis.
  
  
  METHODS
  The study involved 94 patients who underwent laparotomy due to suspected acute appendicitis. Medical examination at hospital admission was performed by a resident and a general surgery specialist. The probability of AA was evaluated using six different scoring systems: Alvarado, Fenyo, Eskelinen, Ohman, Tzankis, and RIPASA. The resident calculated the results in individual systems. The decision to perform the operation was taken by a specialist surgeon who did not know the results.
  
  
  RESULTS
  Normal appendix was removed in 26% of cases. Eskelinen, RIPASA and Alvarado systems showed highest sensitivity (99%, 88% and 85%, respectively). Tzankis and Fenyo systems showed highest specificity (62% and 50%, respectively).
  
  
  CONCLUSIONS
  Our study has shown limited value of scoring systems for the diagnosis of acute appendicitis. The systems may improve diagnostic accuracy as they require obtaining a more detailed medical history, and making a more thorough and organized data analysis. However, the scoring systems should be treated only as an aid to diagnosis.
authors.forename: Dominik A
authors.initials: DA
authors.lastname: Walczak
authors.forename: Dariusz
authors.initials: D
authors.lastname: Pawełczak
authors.forename: Agata
authors.initials: A
authors.lastname: Żółtaszek
authors.forename: Rajmund
authors.initials: R
authors.lastname: Jaguścik
authors.forename: Wojciech
authors.initials: W
authors.lastname: Fałek
authors.forename: Monika
authors.initials: M
authors.lastname: Czerwińska
authors.forename: Karolina
authors.initials: K
authors.lastname: Ptasińska
authors.forename: Piotr W
authors.initials: PW
authors.lastname: Trzeciak
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Pasieka
mesh_terms: D000208:Acute Disease; D001062:Appendectomy; D001064:Appendicitis / Q000145:classification* / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D012720:Severity of Illness Index