Akut apandisit tanısında orijinal Alvarado skorlama sistemi: Kohort çalışma.
Amaç: Akut apandisit en sık görülen akut karın nedeni olmasına rağmen hala kesin tanı koyduran bir yöntem mevcut değildir. Literatürde çeşitli skorlamalar tanımlanmıştır. Bu çalışmada tanıyı desteklemek amaçlı, bir klinik skorlama sistemi olan Alvarado skorununun etkinliği araştırdık. Yöntem: Hastanemiz acil cerrahi servisinde akut karın ve akut apandisit ön tanısı ile ameliyat edilecek hastalara, ameliyat öncesinde Alvarado skorları hesaplandı. Bu skor sistem içerisinde 8 parametre bulunmaktadır. 1-Ağrının sağ alt kadrana göçü, 2-İştahsızlık, 3-Bulantı-kusma, 4-Sağ alt kadranda hassasiyet, 5-Rebound hassasiyet, 6-Ateş, 7-Lökositoz, 8-Sola kayma (granülositoz). 4 ve 7 numara 2 puan diğerleri 1 puan olmak üzere toplam 10 puan üzerinden hesaplanır. Bulgular: Toplam 200 hasta, (128 erkek, 82 bayan, erkek/bayan:1.6) ortalama yaş 34.3±15.6, yaş aralığının 15-78 olduğu görüldü. ROC analizinde 6’nın üzerindeki Alvarado skorlarının %76 sensitivite, %91 spesifisite ile akut apandisit tanısını gösterebileceği saptandı. Alvarado skoru 9-10 %100 sensitivite ile akut apandisiti tespit etti. Sonuçlar: Akut apandisit tanısında klinik skorlama sistemleri sık kullanılmaktadır. Alvarado skorlama sistemini kapsayan yayınlarda 9-10 arası yüksek ihtimal apandisit (cerrahi girişim), 7-8 arası değerler için ileri tetkik yöntemleri önerilmiştir. Çalışmamızda literatürle uyumlu sonuçlanmıştır.
Anahtar Kelimeler:
Akut apandisit, Skorlama sistemleri, Alvarado skoru
Original Alvarado scoring system in the diagnosis of acute appendicitis: A cohort study.
Aims: Although acute appendicitis is the most common cause of acute abdomen, there is still no definitive diagnostic method. Various scores were defined in the literature. In this study, we investigated the effectiveness of the Alvarado score, a clinical scoring system aimed at supporting the diagnosis. Methods: Patients who were to be operated with acute abdomen and acute appendicitis pre-diagnosis in our hospital emergency surgery service were calculated before the Alvarado scores. This score has 8 parameters in the system. 1-The right lower quadrant of pain, 2-anorexia, 3-nausea-vomiting, 4-right lower quadrant sensitivity, 5-rebound sensitivity, 6-fever, 7-leukocytosis, 8-left shift (granulocytosis). Numbers 4 and 7 are calculated with a total of 10 points, 2 points, 1 point. Results: Total 200 patients, (128 males, 82 female, male/female: 1.6) mean age was 34.3 ± 15.6, and the age range was 15-78. In ROC analysis, Alvarado scores greater than 6 has demonstrated acute appendicitis diagnosis with 76% sensitivity and 91% specificity. Alvarado score of 9-10 showed 100% sensitivity to detect acute appendicitis. Conclusions: Clinical scoring systems are frequently used in the diagnosis of acute appendicitis. In publications covering the Alvarado scores of 9-10, the high probability of appendicitis, needs surgical intervention, and advanced examination methods were proposed in scores of 7-8. Our study resulted in consistent with the literature.
Keywords:
Acute appendicitis, Scoring systems, Alvarado score,
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- Başlangıç: 2017
- Yayıncı: Selçuk BAŞAK