Diagnostic value of the MZXBTCH scoring system for acute complex appendicitis

Area of Science:

• Medical Diagnostics
• Surgical Pathology

Background:

• Acute appendicitis is a common surgical emergency.
• Complex appendicitis requires accurate and timely diagnosis to prevent complications.
• Existing scoring systems have limitations in accurately diagnosing complex appendicitis.

Purpose of the Study:

• To develop a novel scoring model, the MZXBTCH system, for diagnosing complex appendicitis.
• To assess the diagnostic value of the MZXBTCH system.
• To compare the MZXBTCH system's efficacy against established scoring systems (Alvarado, RIPASA, AIR).

Main Methods:

• Development of the MZXBTCH scoring system using data from 868 patients.
• Validation of the MZXBTCH system on an independent cohort of 373 patients.
• Comparison of diagnostic performance using Receiver Operating Characteristic (ROC) curves and key metrics (sensitivity, specificity, accuracy).
• Identification of independent risk factors for complex appendicitis via multivariate logistic regression.

Main Results:

• The MZXBTCH system demonstrated a higher Area Under the Curve (AUC) of 0.82 compared to Alvarado (0.66), RIPASA (0.68), and AIR (0.76).
• MZXBTCH achieved superior sensitivity (74.49%) and specificity (76.36%) in diagnosing complex appendicitis.
• Independent risk factors identified include body temperature, C-reactive protein, lymphocyte percentage, fecalith, fat stranding, and appendix diameter.

Conclusions:

• The MZXBTCH scoring system is a more accurate and effective tool for diagnosing complex appendicitis than the Alvarado, RIPASA, and AIR systems.
• The identified independent risk factors provide a basis for the MZXBTCH nomogram.
• This novel scoring system can aid clinicians in improving diagnostic accuracy for complex appendicitis.