Risk Scoring Systems in Patients Planned for Laproscopy Who Have Suspected Acute Appendicitis: A Single-Center Retrospective Study

Abstract

Background: There is at present disagreement over the best way to evaluate patients who have appendicitis; in the Department of General Surgery at Meenakshi Medical College, Hospital and Research Institute, Kanchipuram, there are no national guidelines that may be used to guide clinical management. We looked into the possible advantages of proven risk score systems for individuals who might have appendicitis. Techniques: Enrolled were patients between the ages of 16 and 45 who were having a diagnostic laparoscopy because they may have appendicitis. The negative appendicectomy rate (NAR) was the main objective. The Adult Appendicitis Score (AAS) and the Appendicitis Inflammatory Response Score (AIRS) were the secondary objectives, together with their false negative rate (FNR) and specificity. Results: There were 361 patients in all, 188 (52.1%) of them were female. 287 individuals (79.5%) had appendicectomies. 6.6% was the NAR. During laparoscopy, females had more alternative diagnoses than males, and the former group had a lower likelihood of undergoing appendicectomy (67.6% versus 92.4%, P<0.001). Sixty-two patients (17.2%) underwent pre-operative imaging; computed tomography was the most often used modality, with a specificity and FNR of 83.3% and 12.6%, respectively. The FNR and specificity of the AIRS in males were 7.3% and 44.4%, respectively. The AAS had a 35.7% FNR and 66.7% specificity in females. Conclusions: A low NAR but a substantial incidence of needless laparoscopies were linked to the clinical judgment-based stratification of individuals with probable appendicitis. Risk scoring doesn't seem to be beneficial for young girls in whom routine pre-operative imaging may be considered.