Leucocyte Count Does Not Improve the Diagnostic Performance of a Diagnostic Score (DS) in Distinguishing Acute Appendicitis (AA) from Nonspecific Abdominal Pain (NSAP)

Meklin, Jannica; Eskelinen, M; Syrjänen, Kari; Eskelinen, Matti

doi:10.21873/invivo.12171

Cited by 11 publications

(19 citation statements)

References 4 publications

(4 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinical findings of AC include right upper quadrant pain and tenderness, Murphy's sign, nausea, vomiting, fever and poor appetite. The differential diagnosis of AC among AAP patients can be difficult and may include several different diseases (6,7,(9)(10)(11). There is no specific laboratory test for the diagnosis of AC, but the high leucocyte count might support the AC diagnosis, albeit the Se and Sp are not particularly high as confirmed in the present series; 54% and 43%, respectively.…”

Section: Discussionmentioning

confidence: 50%

“…Criteria for inclusion in this study and diagnostic criteria were those set forth by the Research Committee of the World Organization of Gastroenterology (OMGE) (6)(7)(8)(9). Included in the present study were 636 men (47.7%) and 697 women (52.3%) with a mean age (±SD) of 38.0±22.1 years.…”

Section: Methodsmentioning

confidence: 99%

“…The examination of clinical symptoms, signs and relevant laboratory tests were conducted using a standard technique and the results were graded positive or negative as previously described (6,7,9) (Tables I and II). The diagnosis of AC was done by considering all symptoms, signs and results of the laboratory tests weighted against the accepted diagnostic criteria of AC (4,8).…”

Section: Methodsmentioning

confidence: 99%

“…The AAST grading system has been proposed for use in research as well as in clinical settings. Despite several DS studies in acute abdominal pain (AAP) (6,7), the diagnostic performance of DS in the diagnosis of AC among AAP patients has not been previously studied.…”

mentioning

confidence: 99%

“…In our recent studies, we have analysed the diagnostic accuracy of DS in distinguishing acute appendicitis (AA) from nonspecific abdominal pain (NSAP) as well as the potential gender-specificity of DS in confirming AA (6,7). Prompted by the frequency of AC among AAP patients and the lack of diagnostic performance studies on DS in AC, we designed the present study to assess the relative accuracy of i) a detailed history taking, ii) clinical examination and laboratory testing, and iii) the DS in detecting clinically confirmed AC among patients with AAP.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Performance of a Diagnostic Score in Confirming Acute Cholecystitis Among Patients With Acute Abdominal Pain

et al. 2020

Self Cite

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 50%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Performance of a Diagnostic Score in Confirming Acute Cholecystitis Among Patients With Acute Abdominal Pain

et al. 2020

Self Cite

View full text Add to dashboard Cite

A Diagnostic Score (DS) Is a Powerful Tool in Diagnosis of Acute Appendicitis in Elderly Patients With Acute Abdominal Pain

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background/Aim: Although acute appendicitis (AA) in elderly patients is different from AA in younger patients, the accuracy of diagnostic scores (DSs) in detecting AA is rarely considered. Patients and Methods: A cohort of 470 AAP (acute abdominal pain) patients older than 50 years, including 224 women (53.7%) and 193 men (46.3%), were included in the study. The most significant diagnostic predictors were used to construct DS formulas for AA diagnosis with (Tax+) and without body temperature (Tax-). Meta-analytical techniques were used to calculate the summary Se and Sp estimates for each data sets (historytaking, findings, and DS formulas). Results: In SROC analysis, the AUC values for i) symptoms ii) signs and tests iii) DS Tax-and iv) DS Tax+ were as follows: i) AUC=0.658 (95%CI=0.601-0.709); ii) AUC=0.751 (95%CI=0.701-0.800), iii) AUC=0.977 (95%CI=0.942-1.000), and for iv) AUC=0.980 (95%CI=0.956-1.000). Using roccomp analysis for these AUC values, the differences were significant as follows: between i) and ii) p=0.0358; between i) and iii) p<0.0001; between i) and iv) p<0.0001; between ii) and iii) p<0.0001; between ii) and iv) p<0.0001; and between iii) and iv) p=0.682. Conclusion: Similar to younger AA patients, the DS formula was superior to both the clinical history-taking and findings, and therefore, the use of DS should be an important part of the diagnostic decision tree of AA also in the elderly patients presenting with AAP. Acute appendicitis (AA) in elderly patients is in many respects different from AA in younger patients with acute abdominal pain (AAP). AA among elderly patients might have lower diagnostic accuracy, longer delay from onset of symptoms to admission, and therefore, higher AA perforation rate leading to higher complication and mortality rate. Ceresoli et al. (1) analysed an AA cohort of 16,544 patients and showed, that after adolescence, the incidence of AA decreases along with increasing age (1). In their study on AAP patients, Kraemer et al. (2) reported that 15% of the patients older than 50 years of age had a final diagnosis of AA, as compared to nearly 30% of AA among younger patients (2). However, along with the aging of the Western populations, AA among the elderly is likely to be more common in the future (1). The lack of commonly accepted guidelines and diagnostic scoring (DS) specified for elderly patients with AA (3) encouraged us to evaluate the accuracy of the clinical diagnosis of AA among elderly patients. We designed the present study to assess the relative accuracy of i) a clinical history-taking, ii) clinical findings, as well as iii) the DS without body temperature (Tax-) and iv) the DS with body temperature (Tax+) in detecting clinically confirmed AA among the elderly patients with AAP.

show abstract

A Diagnostic Score for Acute Small Bowel Obstruction

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background/Aim: The diagnosis of acute small bowel obstruction (ASBO) may be difficult and the decision to operate is based on clinical findings. So far, the diagnostic scores (DSs) for ASBO detection have been rarely evaluated. Patients and Methods: A cohort of 1,333 acute abdominal pain (AAP) patients with 54 ASBO patients, were included in the study. The most significant diagnostic findings (in multivariate logistic regression analysis) were used to construct DS formulas for ASBO diagnosis with location of pain at diagnosis (LP+) and without location of pain at diagnosis (LP-). Metaanalytical techniques were used to calculate the summary sensitivity (Se) and specificity (Sp) estimates for each data sets (history-taking, findings, and DS formulas). Results: In SROC analysis, the AUC values for i) clinical history-taking, ii) diagnostic findings and tests, iii) DS LP-and iv) DS LP+ were as follows: i) AUC=0.638 (95%CI=0.600-0.676); ii) AUC=0.694 (95%CI=0.630-0.724), iii) AUC=0.962 (95%CI=0.940-0.986), and for iv) . In roccomp analysis for the AUC values, the differences are significant as follows: between i) and ii) p=0.312; between i) and iii) p<0.0001; between i) and iv) p<0.0001; between ii) and iii) p<0.0001; between ii) and iv) p<0.0001; and between iii) and iv) p=0.317. Conclusion: The present study is the first to provide data that the DS could be used for clinical diagnosis of ASBO without radiological or laboratory analyses, to reach a high diagnostic accuracy in AAP patients.

show abstract

Leucocyte Count Does Not Improve the Diagnostic Performance of a Diagnostic Score (DS) in Distinguishing Acute Appendicitis (AA) from Nonspecific Abdominal Pain (NSAP)

Cited by 11 publications

References 4 publications

Performance of a Diagnostic Score in Confirming Acute Cholecystitis Among Patients With Acute Abdominal Pain

Performance of a Diagnostic Score in Confirming Acute Cholecystitis Among Patients With Acute Abdominal Pain

A Diagnostic Score (DS) Is a Powerful Tool in Diagnosis of Acute Appendicitis in Elderly Patients With Acute Abdominal Pain

A Diagnostic Score for Acute Small Bowel Obstruction

Contact Info

Product

Resources

About