在怀疑尾炎的成年患者中,评分系统的性能和诊断准确性
David Eng Yeow Gan1,2, Nik Ritza Kosai Nik Mahmood2, Jitt Aun Chuah1
1Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia.
Langenbeck's archives of surgery
|July 6, 2023
概括
在这项马来西亚研究中,Raja Isteri Pengiran Anak Saleha (RIPASA) 评分显示了诊断尾炎的最高灵敏度和特异性. 成人尾炎评分 (AAS) 证明是最有效的排除低风险患者.
科学领域:
- 医学诊断 医学诊断 医学诊断
- 外科评估的评估.
- 临床决策支持 临床决策支持
背景情况:
- 准确诊断尾炎对于及时干预至关重要.
- 现有的尾炎评分系统在诊断准确度上有所不同.
- 优化诊断工具可以改善患者的治疗结果和资源配置.
研究的目的:
- 评估和比较四种尾炎评分系统的准确性.
- 为了确定每个评分系统的最佳切断点.
- 确定马来西亚人口中尾炎诊断最有效的评分系统.
主要方法:
- 对245名怀疑患有尾炎的患者进行前性队列研究.
- 使用阿尔瓦拉多,尾炎炎炎症反应 (AIR),Raja Isteri Pengiran Anak Saleha (RIPASA) 和成人尾炎评分 (AAS) 的评分.
- 计算每个系统的灵敏度,特异性和接收器操作特征 (ROC) 曲线与曲线下的面积 (AUC).
主要成果:
- RIPASA评分显示出最高的灵敏度 (72.7%) 和特异性 (62.3%),AUC为0.724.
- 成人尾炎评分 (AAS) 的特异性为75.4%,AUC为0.719.
- 厌食症,右沟的敏感性和守护独立地与尾炎有关.
结论:
- 尾炎评分系统在被研究的人群中显示出中等的诊断性能.
- 在马来西亚的背景下,RIPASA评分是最敏感,最具体,最易于使用的.
- 在低风险人群中排除尾炎时,AAS是最准确的.
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