Clinical Prediction Score for Ruptured Appendicitis in ED
Background. Ruptured appendicitis has a high morbidity and mortality and requires immediate surgery. The Alvarado Score is used as a tool to predict the risk of acute appendicitis, but there is no such score for predicting rupture. This study aimed to develop the prediction score to determine the li...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2021/6947952 |
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| author | Thidathit Prachanukool Chaiyaporn Yuksen Welawat Tienpratarn Sorravit Savatmongkorngul Panvilai Tangkulpanich Chetsadakon Jenpanitpong Yuranun Phootothum Malivan Phontabtim Promphet Nuanprom |
| author_facet | Thidathit Prachanukool Chaiyaporn Yuksen Welawat Tienpratarn Sorravit Savatmongkorngul Panvilai Tangkulpanich Chetsadakon Jenpanitpong Yuranun Phootothum Malivan Phontabtim Promphet Nuanprom |
| author_sort | Thidathit Prachanukool |
| collection | DOAJ |
| description | Background. Ruptured appendicitis has a high morbidity and mortality and requires immediate surgery. The Alvarado Score is used as a tool to predict the risk of acute appendicitis, but there is no such score for predicting rupture. This study aimed to develop the prediction score to determine the likelihood of ruptured appendicitis in an Asian population. Methods. This study was a diagnostic, retrospective cross-sectional study in the Emergency Medicine Department of Ramathibodi Hospital between March 2016 and March 2018. The inclusion criteria were age >15 years and an available pathology report after appendectomy. Clinical factors included gender, age>60 years, right lower quadrant pain, migratory pain, nausea and/or vomiting, diarrhea, anorexia, fever>37.3°C, rebound tenderness, guarding, white blood cell count, polymorphonuclear white blood cells (PMN) > 75%, and pain duration before presentation. The predictive model and prediction score for ruptured appendicitis were developed by multivariable logistic regression analysis. Result. During the study period, 480 patients met the inclusion criteria; of these, 77 (16%) had ruptured appendicitis. Five independent factors were predictive of rupture, age>60 years, fever>37.3°C, guarding, PMN>75%, and duration of pain>24 hours to presentation. A score >6 increased the likelihood ratio of ruptured appendicitis by 3.88 times. Conclusion. Using the Ramathibodi Welawat Ruptured Appendicitis Score (RAMA WeRA Score) developed in this study, a score of >6 was associated with ruptured appendicitis. |
| format | Article |
| id | doaj-art-366cce85356845389525be290cb89ce2 |
| institution | Kabale University |
| issn | 2090-2840 2090-2859 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-366cce85356845389525be290cb89ce22025-02-03T01:29:21ZengWileyEmergency Medicine International2090-28402090-28592021-01-01202110.1155/2021/69479526947952Clinical Prediction Score for Ruptured Appendicitis in EDThidathit Prachanukool0Chaiyaporn Yuksen1Welawat Tienpratarn2Sorravit Savatmongkorngul3Panvilai Tangkulpanich4Chetsadakon Jenpanitpong5Yuranun Phootothum6Malivan Phontabtim7Promphet Nuanprom8Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandDepartment of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandDepartment of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandDepartment of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandDepartment of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandDepartment of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandDepartment of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandDepartment of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandDepartment of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandBackground. Ruptured appendicitis has a high morbidity and mortality and requires immediate surgery. The Alvarado Score is used as a tool to predict the risk of acute appendicitis, but there is no such score for predicting rupture. This study aimed to develop the prediction score to determine the likelihood of ruptured appendicitis in an Asian population. Methods. This study was a diagnostic, retrospective cross-sectional study in the Emergency Medicine Department of Ramathibodi Hospital between March 2016 and March 2018. The inclusion criteria were age >15 years and an available pathology report after appendectomy. Clinical factors included gender, age>60 years, right lower quadrant pain, migratory pain, nausea and/or vomiting, diarrhea, anorexia, fever>37.3°C, rebound tenderness, guarding, white blood cell count, polymorphonuclear white blood cells (PMN) > 75%, and pain duration before presentation. The predictive model and prediction score for ruptured appendicitis were developed by multivariable logistic regression analysis. Result. During the study period, 480 patients met the inclusion criteria; of these, 77 (16%) had ruptured appendicitis. Five independent factors were predictive of rupture, age>60 years, fever>37.3°C, guarding, PMN>75%, and duration of pain>24 hours to presentation. A score >6 increased the likelihood ratio of ruptured appendicitis by 3.88 times. Conclusion. Using the Ramathibodi Welawat Ruptured Appendicitis Score (RAMA WeRA Score) developed in this study, a score of >6 was associated with ruptured appendicitis.http://dx.doi.org/10.1155/2021/6947952 |
| spellingShingle | Thidathit Prachanukool Chaiyaporn Yuksen Welawat Tienpratarn Sorravit Savatmongkorngul Panvilai Tangkulpanich Chetsadakon Jenpanitpong Yuranun Phootothum Malivan Phontabtim Promphet Nuanprom Clinical Prediction Score for Ruptured Appendicitis in ED Emergency Medicine International |
| title | Clinical Prediction Score for Ruptured Appendicitis in ED |
| title_full | Clinical Prediction Score for Ruptured Appendicitis in ED |
| title_fullStr | Clinical Prediction Score for Ruptured Appendicitis in ED |
| title_full_unstemmed | Clinical Prediction Score for Ruptured Appendicitis in ED |
| title_short | Clinical Prediction Score for Ruptured Appendicitis in ED |
| title_sort | clinical prediction score for ruptured appendicitis in ed |
| url | http://dx.doi.org/10.1155/2021/6947952 |
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