用临床和计算机断层扫描结果对成年人复杂尾炎预测的评分系统的验证
Rathachai Kaewlai1, Sasima Tongsai2, Wanwarang Teerasamit3
1Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd, Bangkok Noi,, Bangkok, 10700, Thailand. rathachai@gmail.com.
Insights into imaging
|November 16, 2023
概括
几种评分系统可以预测成年人的复杂尾炎. 这些系统,包括修改和新系统,显示出高精度,并可能有助于选择患者进行非手术治疗.
科学领域:
- 放射学 放射学是一门学科.
- 手术病理学手术病理学
背景情况:
- 急性尾炎是一种常见的手术紧急情况.
- 计算机断层扫描 (CT) 经常用于诊断.
- 区分复杂和非复杂的尾炎对于治疗决策至关重要.
研究的目的:
- 评估现有和新型评分系统的诊断性能,用于预测成人复杂尾炎.
- 确定复杂尾炎的临床和成像预测因素.
- 评估这些评分系统在指导非操作性管理中的有用性.
主要方法:
- 对325名CT诊断为急性尾炎的成年患者进行了回顾性分析.
- 复杂和无复杂尾炎组之间的临床和成像发现的比较.
- 修改了5个现有的评分系统,因为缺少C-反应蛋白数据.
- 通过使用接收器运行特性曲线 (AUC) 下面的面积来评估8个修改系统和1个新系统.
- 建议的评分系统的内部验证.
主要成果:
- 复杂的尾炎在36.8%的患者中存在.
- 有意义的预测因素包括症状持续时间>12小时,尾炎,脂肪滞留,液体和外空气 (AUCs 0.824-0.829).
- 9个评分系统的AUC范围从0.692到0.831.
- 修改过的Atema,Kim HY和拟议的得分显示了可比较高的AUC (0.793-0.831).
- 内部验证显示AUC高 (0.826-0.844),其中一个建议的得分达到100%的灵敏度和NPV.
结论:
- 某些评分系统,包括修改和新提议的评分系统,对复杂尾炎具有很高的预测价值.
- 这些系统表现出良好的灵敏度和合理的特异性.
- 这些发现表明,这些评分系统可能有助于选择成人患者进行非手术治疗急性尾炎.
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