Diagnostic Accuracy Rates of Appendicitis Scoring Systems for the Stratified Age Groups

Area of Science:

• Surgical diagnostics
• Medical scoring systems
• Geriatric medicine

Background:

• Acute appendicitis is a common surgical emergency.
• Existing scoring systems may have varying accuracy across different age demographics.
• Physiological changes in older adults can affect diagnostic assessments.

Purpose of the Study:

• To compare the predictive performance of various acute appendicitis scoring systems across distinct age groups.
• To identify age-specific optimal scoring systems for diagnosing acute appendicitis.
• To inform clinical practice regarding the selection of diagnostic tools based on patient age.

Main Methods:

• Prospective study including 203 patients with prediagnosed acute appendicitis.
• Patients categorized into three age groups: 18-45, 46-65, and >65 years.
• Comparison of nine common acute appendicitis scoring systems within each age group.

Main Results:

• The Alvarado scoring system was most accurate for the 18-45 age group.
• The Fenyo-Lindberg scoring system demonstrated highest accuracy for the 46-65 age group.
• The Eskelinen scoring system was most accurate for the >65 age group, but with limitations.

Conclusions:

• Patient age is a critical factor in selecting an appropriate acute appendicitis scoring system.
• The Alvarado and Fenyo-Lindberg systems are recommended for younger and middle-aged adults, respectively.
• The Eskelinen system shows promise for older adults, but further validation is needed for standalone use.