DIALAPP: a prospective validation of a new diagnostic algorithm for acute appendicitis.

Langenbeck's Archives of Surgery
Patrizia MalkomesAndreas A Schnitzbauer

Abstract

The management of patients with suspected appendicitis remains a challenge in daily clinical practice, and the optimal management algorithm is still being debated. Negative appendectomy rates (NAR) continue to range between 10 and 15%. This prospective study evaluated the accuracy of a diagnostic pathway in acute appendicitis using clinical risk stratification (Alvarado score), routine ultrasonography, gynecology consult for females, and selected CT after clinical reassessment. Patients presenting with suspected appendicitis between November 2015 and September 2017 from age 18 years and above were included. Decision-making followed a clear management pathway. Patients were followed up for 6 months after discharge. The hypothesis was that the algorithm can reduce the NAR to a value of under 10%. A total of 183 patients were included. In 65 of 69 appendectomies, acute appendicitis was confirmed by histopathology, corresponding to a NAR of 5.8%. Notably, all 4 NAR appendectomies had other pathologies of the appendix. The perforation rate was 24.6%. Only 36 patients (19.7%) received a CT scan. The follow-up rate after 30 days achieved 69%, including no patients with missed appendicitis. The sensitivity and specificity of the diagno...Continue Reading

Associated Clinical Trials

References

May 1, 1986·Annals of Emergency Medicine·A Alvarado
Nov 9, 2000·The European Journal of Surgery = Acta Chirurgica·R E AnderssonG P Olaison
Jul 3, 2002·Archives of Surgery·David R Flum, Thomas Koepsell
Apr 11, 2003·Digestive Surgery·C L BijnenD J Gouma
Oct 7, 2004·Annals of Internal Medicine·Teruhiko TerasawaR Jeffrey Kohlwes
Nov 29, 2005·Journal of the American College of Surgeons·David R FlumThomas Koepsell
Nov 23, 2006·Journal of the American College of Surgeons·Jared L AntevilCarlos V R Brown
Dec 29, 2006·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Christopher C LeeHoward Levinson
Jan 16, 2007·World Journal of Surgery·George TzovarasConstantine Hatzitheofilou
Apr 7, 2007·Journal of the American College of Radiology : JACR·C Craig Blackmore, Teruhiko Terasawa
Nov 30, 2007·The New England Journal of Medicine·David J Brenner, Eric J Hall
Dec 25, 2007·The Journal of Emergency Medicine·David A GussDominick Munassi
Oct 22, 2008·Annals of Surgery·UNKNOWN SCOAP CollaborativeRichard Thirlby
Dec 17, 2009·Archives of Internal Medicine·Rebecca Smith-BindmanDiana L Miglioretti
Jun 29, 2010·World Journal of Surgery·Boudewijn R ToorenvlietJaap F Hamming
Jun 22, 2011·Annals of Internal Medicine·Perry J PickhardtRichard J Bruce
Nov 9, 2011·Journal of the Korean Surgical Society·Omer EnginGulnihal Ay Coskun
Dec 30, 2011·BMC Medicine·Robert OhleBorislav D Dimitrov
Apr 27, 2012·The New England Journal of Medicine·Kyuseok KimKyoung Ho Lee
Sep 12, 2012·Annals of Surgery·Frederick Thurston DrakeUNKNOWN SCOAP Collaborative
Dec 29, 2013·AJR. American Journal of Roentgenology·Laurence ParkerAndrea J Frangos
Mar 19, 2014·Langenbeck's Archives of Surgery·Juliane LieseChristoph W Strey
Mar 14, 2017·Annals of Surgery·Mollie FerrisGilaad G Kaplan
Jul 22, 2017·The British Journal of Surgery·M AnderssonUNKNOWN STRAPPSCORE Study Group

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Citations

Jul 3, 2021·Journal of Clinical Medicine·Raminta Luksaite-LuksteTomas Poskus

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Methods Mentioned

BETA
cesarean section

Clinical Trials Mentioned

NCT02627781

Software Mentioned

BiAS
Excel
DIALAPP

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