Validation of a Scoring System to Distinguish Uncomplicated From Complicated Appendicitis

Geerdink, Thijs H.; Augustinus, Simone; Atema, Jasper J.; Jensch, Sebastiaan; Vrouenraets, B. C.; Castro, S. M. M. de

doi:10.1016/j.jss.2020.08.050

Cited by 14 publications

(12 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, preoperative differentiation of UCAA cases gains importance. In this study, the rate of CAA was 16.7% and this was consistent with the literature [14,15].…”

Section: Discussionsupporting

confidence: 93%

“…In our study, we found that WBC did not differ significantly between groups (AUC: 0.549, AUC: 0.595). In the external validation study by Gerrdink et al [14], we saw that they reached a similar result with AUC of 0.55.…”

Section: Discussionsupporting

confidence: 70%

“…Although statistical significance and internal validation have been performed, such scientific interpretations need to be tested in larger populations and different regions to demonstrate their usability. Geerdink et al performed external validation of the model using USG results [14]. Our study presented the external validation of both the model using USG results and the model using CT results.…”

Section: Discussionmentioning

confidence: 92%

“…In the original study, c-index values were Kubat M et al Differentiation of Uncomplicated Appendicitis 0.82 for the scoring system using USG results and 0.88 for the scoring system using CT results [13]. In the external validation study by Geerdink et al, the c-index values for the scoring system using USG results were 0.83 [14]. In our study, we found the c-index values to be 0.87 for the scoring system using USG results and 0.92 for the scoring system using CT results.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Validation and Efficiency of a Scoring System Used in the Differentiation of Uncomplicated Appendicitis

Kubat¹,

Şahin

2022

Acta Medica Alanya

View full text Add to dashboard Cite

Amaç: Komplike-komplike olmayan apandisit vakalarını ayırt etmek için çeşitli parametreler kullanılmakta ve hatta bu parametrelerin birlikte kullanıldığı skorlama sistemleri oluşturulmaktadır. Bu çalışmanın amacı, bu puanlama sistemlerinden birinin etkinliğini dış doğrulama ile değerlendirmektir. Yöntemler: Ocak 2018-Ocak 2021 tarihleri arasında apendektomi yapılan hastaların klinik, radyolojik ve laboratuvar bulguları retrospektif olarak değerlendirildi. Görüntüleme sonucunda akut apandisit düşünülen her hasta için daha önce tanımlanan skorlama sistemleri kullanılarak skorlama yapıldı. Klinik ve patolojik değerlendirme sonuçlarına göre komplike apandisit ve komplike olmayan apandisit gruplarına ayrıldılar. Bulgular: 425 hasta değerlendirilirken hastaların %48'inde ultrasonografi, %52'sinde tomografi kullanıldı. Tomografi kullanan grupta ≤6 puanın anlamlı etkinliği gözlendi (p<0,001, EAA: 0.838, Duyarlılık %83,3, pozitif öngörü değeri %50,8, özgüllük %84,3, negatif öngörü değeri %96,3). Ultrasonografi grubunda ≤5 skorunun anlamlı etkinliği gözlendi (p<0,001, EAA: 0.790, Duyarlılık %85,7, pozitif prediktif değer %39,0, spesifisite %72,2, negatif prediktif değer %96,1). Sonuç: Komplike olmayan apandisit vakalarının seçimi için oluşturulan puanlama sisteminin etkili olduğu gösterilmiştir ve harici olarak doğrulanmıştır. Skorlama sisteminde kullanılan parametrelerin her biri bağımsız etkinliğinden daha yüksek verimliliğe sahip olduğundan; klinik, radyolojik ve laboratuvar değişkenlerini bir arada değerlendiren skorlama sistemleri klinik uygulamada daha iyi sonuçlar vermektedir.

show abstract

“…Therefore, preoperative differentiation of UCAA cases gains importance. In this study, the rate of CAA was 16.7% and this was consistent with the literature [14,15].…”

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Validation and Efficiency of a Scoring System Used in the Differentiation of Uncomplicated Appendicitis

Kubat¹,

Şahin

2022

Acta Medica Alanya

View full text Add to dashboard Cite

show abstract

“…Appendectomy for acute appendicitis (AA) is the most commonly performed emergency surgical procedure worldwide with very low mortality and morbidity rates (1). Due to the advancements in imaging techniques and accessibility of healthcare services, vast majority of the cases are uncomplicated (2,3).…”

Section: Introductionmentioning

confidence: 99%

COVID-19 outbreak and acute appendicitis: Does the lockdown has a influence on appendectomies?-A single center retrospective cohort study

et al. 2022

View full text Add to dashboard Cite

Objective: Healthcare systems have been negatively affected from COVID-19 pandemic worldwide. Elective surgical procedures were postponed and conservative treatment options were considered even in urgent conditions. This study aimed to explore the influence of the COVID-19 pandemic on urgent appendectomy in a pandemic hospital. Material and Methods: Patients on whom appendectomy was performed between March 2020- June 2020 were included into the study (pandemic group). For comparison, control group patients were selected in the same period of 2019 (control group). Patients’ demographics, laboratory and radiological findings, length of hospital stay, complications and histopathological findings of the groups were compared. Results: Forty-six patients were included in pandemic group and and one hundred-one in the control group. Patient characteristics were similar in both groups. There were no significant differences in type of surgery, complications, laboratory and histopathological findings. In the control group, length of hospital stay was longer when compared with the pandemic group. Conclusion: Although the number of appendectomies performed decreased significantly during the COVID-19 pandemic, perioperative parameters were similar in both groups

show abstract

Development and Validation of the Scoring System of Appendicitis Severity 2.0

Scheijmans,

Bom,

Ghori

et al. 2024

JAMA Surg

View full text Add to dashboard Cite

ImportanceWhen considering nonoperative treatment in a patient with acute appendicitis, it is crucial to accurately rule out complicated appendicitis. The Atema score, also referred to as the Scoring System of Appendicitis Severity (SAS), has been designed to differentiate between uncomplicated and complicated appendicitis but has not been prospectively externally validated.ObjectiveTo externally validate the SAS and, in case of failure, to develop an improved SAS (2.0) for estimating the probability of complicated appendicitis.Design, Setting, and ParticipantsThis prospective study included adult patients who underwent operations for suspected acute appendicitis at 11 hospitals in the Netherlands between January 2020 and August 2021.Main Outcomes and MeasuresAppendicitis severity was predicted according to the SAS in 795 patients and its sensitivity and negative predictive value (NPV) for complicated appendicitis were calculated. Since the predefined targets of 95% for both were not met, the SAS 2.0 was developed using the same cohort. This clinical prediction model was developed with multivariable regression using clinical, biochemical, and imaging findings. The SAS 2.0 was externally validated in a temporal validation cohort consisting of 565 patients.ResultsIn total, 1360 patients were included, 463 of whom (34.5%) had complicated appendicitis. Validation of the SAS resulted in a sensitivity of 83.6% (95% CI, 78.8-87.6) and an NPV of 85.0% (95% CI, 80.6-88.8), meaning that the predefined targets were not achieved. Therefore, the SAS 2.0 was developed, internally validated (C statistic, 0.87; 95% CI, 0.84-0.89), and subsequently externally validated (C statistic, 0.86; 95% CI, 0.82-0.89). The SAS 2.0 was designed to calculate a patient’s individual probability of having complicated appendicitis along with a 95% CI.Conclusions and RelevanceIn this study, external validation of the SAS fell short in accurately distinguishing complicated from uncomplicated appendicitis. The newly developed and externally validated SAS 2.0 was able to assess an individual patient’s probability of having complicated appendicitis with high accuracy in patients with acute appendicitis. Use of this patient-specific risk assessment tool can be helpful when considering and discussing nonoperative treatment of acute appendicitis with patients.

show abstract

Validation of a Scoring System to Distinguish Uncomplicated From Complicated Appendicitis

Cited by 14 publications

References 29 publications

Validation and Efficiency of a Scoring System Used in the Differentiation of Uncomplicated Appendicitis

Validation and Efficiency of a Scoring System Used in the Differentiation of Uncomplicated Appendicitis

COVID-19 outbreak and acute appendicitis: Does the lockdown has a influence on appendectomies?-A single center retrospective cohort study

Development and Validation of the Scoring System of Appendicitis Severity 2.0

Contact Info

Product

Resources

About