Comparing the Accuracy of Ohmann and Alvarado Scoring Systems in Detection of Acute Appendicitis; a Cross-Sectional Study
Archives of Academic Emergency Medicine,
Vol. 9 No. 1 (2021),
1 January 2021
,
Page e37
https://doi.org/10.22037/aaem.v9i1.1187
Abstract
Introduction: Alvarado Scoring System (ASS) and Ohmann Scoring System (OSS) are two scoring systems for diagnosing acute appendicitis (AA). This study was designed to compare the diagnostic accuracy of the two mentioned scores in detection of acute abdominal cases at risk for AA.
Methods: In this prospective cross-sectional study, patients admitted to the emergency departments of two academic hospitals in Qom, Iran, with right lower quadrant (RLQ) abdominal pain suspected to AA were evaluated. All cases were scored using ASS and OSS, and screening performance characteristics of the two scores were calculated and reported considering the pathologic findings as a gold standard.
Results: 174 patients with a preliminary AA diagnosis and the mean age of 38.1 ± 10.63 years (11- 73) were included in this study (62.07% male). At the optimal cutoff point of ≥7 for the ASS, the sensitivity and the specificity were 46.43% (95% CI: 37.97%-55.07%), 97.05% (95% CI: 84.67%-92.93%), respectively. At the optimal cutoff point of ≥11 for the OSS, the sensitivity and the specificity were 74.29% (95% CI: 66.22%-81.29%), and 55.88% (95% CI: 37.89% - 72.82%), respectively.
Conclusion: Based on the finding of this study, the ASS ≥ 7 was more accurate than the OSS ≥ 11 for detection of AA. But it should be considered that the overall accuracy of Alvarado and Ohmann scores in this regard were fair (0.83) and poor (0.67), respectively.
- appendicitis
- Decision Support Systems
- Clinical
- Data Accuracy
- Comparative Study
How to Cite
References
Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. American journal of epidemiology. 1990;132(5):910-25.
Sartelli M, Baiocchi GL, Di Saverio S, Ferrara F, Labricciosa FM, Ansaloni L, et al. Prospective observational study on acute appendicitis worldwide (POSAW). World Journal of Emergency Surgery. 2018;13(1):1-10.
Ferris M, Quan S, Kaplan BS, Molodecky N, Ball CG, Chernoff GW, et al. The global incidence of appendicitis: a systematic review of population-based studies. Annals of surgery. 2017;266(2):237-41.
Ghasemian Moghaddam MR, Hassanzadeh-Taheri M, Hosseini M, Salimi M, Hassanzadeh-Taheri M. Epidemiological aspects of patients underwent appendectomy in Birjand, Iran, from May 2017 to 2019. Journal of Surgery and Trauma. 2019;7(3):91-7.
Di Saverio S, Birindelli A, Kelly MD, Catena F, Weber DG, Sartelli M, et al. WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis. World Journal of Emergency Surgery. 2016;11(1):1-25.
Golden SK, Harringa JB, Pickhardt PJ, Ebinger A, Svenson JE, Zhao Y-Q, et al. Prospective evaluation of the ability of clinical scoring systems and physician-determined likelihood of appendicitis to obviate the need for CT. Emergency Medicine Journal. 2016;33(7):458-64.
Agarwal R, Agarwal A, Kumar A, Kumar M. The validity and utility of combining ultrasonography with different clinical scores in diagnosis of acute appendicitis. International Surgery Journal. 2019;6(4):1084-92.
Varadhan KK, Neal KR, Lobo DN. Safety and efficacy of antibiotics compared with appendicectomy for treatment of uncomplicated acute appendicitis: meta-analysis of randomised controlled trials. Bmj. 2012;344.
Ceylan B, Aslan T, Çınar A, Kurt AR, Akkoyunlu Y. Can platelet indices be used as predictors of complication in subjects with appendicitis? Wiener klinische Wochenschrift. 2016;128(8):620-5.
Raptis DA, Eshmuminov D, Tschuor C, Limani P, Neff T, Reding T, et al. diagnostic value of pancreatic stone protein in comparison to white cell count and c reactive protein in the diagnosis of acute appendicitis a prospective multicenterdiagnostic accuracy trial. Journal of Surgery. 2019.
Koppad SN, Vandakudri AB, Desai M, Kodliwadmath H. Evaluation of Ohmann score and correlation with ultrasound for diagnosing acute appendicitis. Int J Orthopaed Traumatol Surg Sci. 2016;2(1):234-8.
Yılmaz EM, Kapçı M, Çelik S, Manoğlu B, Avcil M, Karacan E. Should Alvarado and Ohmann scores be real indicators for diagnosis of appendicitis and severity of inflammation? Turkish Journal of Trauma and Emergency Surgery. 2017;23(1):29-33.
Sencan A, Aksoy N, Yıldız M, Okur Ö, Demircan Y, Karaca İ. The evaluation of the validity of Alvarado, Eskelinen, Lintula and Ohmann scoring systems in diagnosing acute appendicitis in children. Pediatric surgery international. 2014;30(3):317-21.
Korkut M, Bedel C, Karancı Y, Avcı A, Duyan M. Accuracy of Alvarado, Eskelinen, Ohmann, RIPASA and Tzanakis scores in diagnosis of acute appendicitis; a cross-sectional study. Archives of academic emergency medicine. 2020;8(1).
Davis GN, Swaminathan M. Acute appendicitis-new diagnostic algorithm using RIPASA score and non-contrast Computeed Tomography Scan. JPMA J Pak Med Assoc. 2019;69(1^ s1).
Schneider C, Kharbanda A, Bachur R. Evaluating appendicitis scoring systems using a prospective pediatric cohort. Annals of emergency medicine. 2007;49(6):778-84. e1.
Kariman H, Shojaee M, Sabzghabaei A, Khatamian R, Derakhshanfar H, Hatamabadi H. Evaluation of the Alvarado score in acute abdominal pain. Ulus Travma Acil Cerrahi Derg. 2014;20(2):86-90.
Kiyak G, Korukluoğlu B, Ozgün Y, Devay AO, Kuşdemir A. Evaluation of Ohmann and Eskelinen scores, leukocyte count and ultrasonography findings for diagnosis of appendicitis. Ulusal travma ve acil cerrahi dergisi= Turkish journal of trauma & emergency surgery: TJTES. 2009;15(1):77-81.
Erdem H, Çetinkünar S, Daş K, Reyhan E, Değer C, Aziret M, et al. Alvarado, Eskelinen, Ohhmann and Raja Isteri Pengiran Anak Saleha appendicitis scores for diagnosis of acute appendicitis. World Journal of Gastroenterology: WJG. 2013;19(47):9057.
Baird DL, Simillis C, Kontovounisios C, Rasheed S, Tekkis PP. Acute appendicitis. Bmj. 2017;357.
Humes D, Simpson J. Acute appendicitis. Bmj. 2006;333(7567):530-4.
- Abstract Viewed: 1161 times
- pdf Downloaded: 546 times
