Przeglad gastroenterologiczny · 2025
The role of clinical, laboratory, and imaging findings in the diagnosis of appendicitis: a retrospective analysis.
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Miteva Nina, Mulita Francesk, Papatriantafyllou Athanasios, Leivaditis Vasileios, Tripsianis Gregory, Deftereos Savas, Vafiadis Konstantinos, Mitrakas Alexandros, Karayiannakis Anastasios, Pitiakoudis Michail, Romanidis Konstantinos
Аннотация
INTRODUCTION: Appendicitis represents a prevalent surgical emergency globally, posing a significant risk of severe complications. These complications encompass a spectrum of conditions, including ileus, peritonitis, abscess formation, and, in extreme cases, mortality.
AIM: The present study aims to assess the association of existing risk scores for the diagnosis of acute appendicitis and patient characteristics with the diagnosis of acute appendicitis, the odds of operative vs non-operative management, and postoperative outcomes.
MATERIAL AND METHODS: In total, 109 patients assessed for acute appendicitis were included in this study.
RESULTS: Sex (p = 0.99, OR = 1.01, 95% CI: 0.87-1.17) and age (p = 0.23, OR = 1.01, 95% CI: 0.98-1.04) were not found to be significantly associated with the diagnosis of appendicitis. Patients with radiating pain were significantly less likely to be diagnosed with appendicitis compared to those with localized pain (p = 4.05 × 10-6, RR = 0.0918, 95% CI: 0.039-0.217). The duration of symptoms did not significantly influence the diagnosis (p = 0.12, RR = 1.04, 95% CI: 0.98-1.11). Increased ALVARADO scores were significantly associated with operative treatment, with patients receiving an appendicectomy having a mean score of 7.56 (SD 1.91) and patients undergoing conservative management having a mean score of 4.92 (SD 1.56) (p-value < 0.001).
CONCLUSIONS: The results of this study highlight the importance of clinical presentation, physical examination findings, and specific laboratory markers in the diagnosis of appendicitis. While demographic factors and certain biomarkers did not show significant associations, the combination of clinical and laboratory data can aid in accurate diagnosis and timely intervention.
AIM: The present study aims to assess the association of existing risk scores for the diagnosis of acute appendicitis and patient characteristics with the diagnosis of acute appendicitis, the odds of operative vs non-operative management, and postoperative outcomes.
MATERIAL AND METHODS: In total, 109 patients assessed for acute appendicitis were included in this study.
RESULTS: Sex (p = 0.99, OR = 1.01, 95% CI: 0.87-1.17) and age (p = 0.23, OR = 1.01, 95% CI: 0.98-1.04) were not found to be significantly associated with the diagnosis of appendicitis. Patients with radiating pain were significantly less likely to be diagnosed with appendicitis compared to those with localized pain (p = 4.05 × 10-6, RR = 0.0918, 95% CI: 0.039-0.217). The duration of symptoms did not significantly influence the diagnosis (p = 0.12, RR = 1.04, 95% CI: 0.98-1.11). Increased ALVARADO scores were significantly associated with operative treatment, with patients receiving an appendicectomy having a mean score of 7.56 (SD 1.91) and patients undergoing conservative management having a mean score of 4.92 (SD 1.56) (p-value < 0.001).
CONCLUSIONS: The results of this study highlight the importance of clinical presentation, physical examination findings, and specific laboratory markers in the diagnosis of appendicitis. While demographic factors and certain biomarkers did not show significant associations, the combination of clinical and laboratory data can aid in accurate diagnosis and timely intervention.