Derivation and validation of the APPEND score: an acute appendicitis clinical prediction rule

ANZ Journal of Surgery
Hinetamatea MikaereAndrew D MacCormick

Abstract

Although many clinical prediction rules (CPRs) for appendicitis exist, none have been developed for a New Zealand population presenting with right iliac fossa (RIF) pain. The aim of this study was to derive and validate an appendicitis CPR for our population. This is a retrospective review of all patients from December 2010 to February 2012 of at least 15 years of age presenting to the general surgery service with RIF pain. Patient data were divided into derivation and validation groups. Univariate and multiple regression analyses identified significant predictors of appendicitis which were used to construct a CPR. A retrospective validation study was then performed and the CPR was refined accordingly. Finally, the accuracy of the CPR was tested. The final components of the new CPR, the APPEND score, were Anorexia, migratory Pain, local Peritonism, Elevated C-reactive protein, Neutrophilia and male gender (Dude). This CPR has an area under the receiver operating characteristic curve of 0.84. The CPR can stratify patients into low, intermediate and high-risk groups which may standardize patient care and reduce the negative appendicectomy rate. A new CPR for predicting appendicitis, in patients presenting with RIF pain, has been ...Continue Reading

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Citations

Feb 6, 2020·Surgical Infections·Kovi E Bessoff, Joseph D Forrester
Dec 5, 2019·The British Journal of Surgery·A Bhangu, UNKNOWN RIFT Study Group on behalf of the West Midlands Research Collaborative
Mar 24, 2020·The Lancet Child & Adolescent Health·UNKNOWN RIFT Study Group on behalf of the West Midlands Research Collaborative

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