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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한응급의학회 Clinical and Experimental Emergency Medicine Clinical and Experimental Emergency Medicine Vol.4 No.4
- 발행연도
- 2017.1
- 수록면
- 214 - 221 (8page)
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초록· 키워드
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Objective Adult appendicitis (AA) with equivocal computed tomography (CT) findings remains a diagnostic challenge for physicians. Herein we evaluated the diagnostic performance of several clinical scoring systems in adult patients with suspected appendicitis and equivocal CT findings. Methods We retrospectively evaluated 189 adult patients with equivocal CT findings. Alvarado, Eskelinen, appendicitis inflammatory response, Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA), and adult appendicitis score (AAS) scores were evaluated, receiver operating characteristic analysis was conducted, and the optimal, low, and high cut-off values were determined for patient classification into three groups: low, intermediate, or high. Results In total, 61 patients were included in the appendicitis group and 128 in the non-appendicitis group. There were no significant differences between the area under the curve of the clinical scoring systems in the final diagnosis of AA for equivocal appendicitis on CT (Alvarado, 0.698; Eskelinen, 0.710; appendicitis inflammatory response, 0.668; RIPASA, 0.653; AAS, 0.726). A RIPASA score greater than 7.5 had a high positive predictive value (90.9) and an AAS score less than or equal to 5 had a high negative predictive value (91.7) in the diagnosis of AA. Conclusion The accuracy of clinical scoring systems in the diagnosis of AA with equivocal CT findings was moderate. Therefore, a high RIPASA score may assist in the diagnosis of AA in patients with equivocal CT findings, and a low AAS score may be used as a criterion for patient discharge. Most patients presented with intermediate scores. The patients with equivocal CT findings may be considered as a third diagnostic category of AA.
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참고문헌 (20)
참고문헌 신청
Andersson RE / 2004 / Meta-analysis of the clinical and laboratory diagnosis of appendicitis / Br J Surg 91:28~37
Impellizzeri P / 2002 / Utility of a scoring system in the diagnosis of acute appendicitis in pediatric age: a retrospective study / Minerva Chir 57:341~346
Jones K / 2004 / Are negative appendectomies still acceptable? / Am J Surg 188:748~754
Vadeboncoeur TF / 2006 / Impact of helical computed tomography on the rate of negative appendicitis / Am J Emerg Med 24:43~47
Sun JS / 2008 / Receiver operating characteristic analysis of the diagnostic performance of a computed tomographic examination and the Alvarado score for diagnosing acute appendicitis: emphasis on age and sex of the patients / J Comput Assist Tomogr 32:386~391
Impellizzeri P / 2002 / Utility of a scoring system in the diagnosis of acute appendicitis in pediatric age: a retrospective study / Minerva Chir 57:341~346
Jones K / 2004 / Are negative appendectomies still acceptable? / Am J Surg 188:748~754
Vadeboncoeur TF / 2006 / Impact of helical computed tomography on the rate of negative appendicitis / Am J Emerg Med 24:43~47
Sun JS / 2008 / Receiver operating characteristic analysis of the diagnostic performance of a computed tomographic examination and the Alvarado score for diagnosing acute appendicitis: emphasis on age and sex of the patients / J Comput Assist Tomogr 32:386~391
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