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Clinical scoring systems have been used in the diagnosis of acute appendicitis and they have had varying degrees of success. The most common scoring system is the Alvarado scoring system followed by other scoring systems like the RIPASA and AIR systems. Most of the scoring systems are good at ruling out appendicitis or selecting patients who may require further imaging like ultrasound or computerized tomography. On their own most clinical scoring systems are not used to solely diagnose acute appendicitis and we have conducted this review article to look at the common scoring systems that are being used and its sensitivity and specificity.
Mundada AV, Lamture Y, Yeola M. Scoring Systems in Acute Appendicitis - A Review. J Evol Med Dent Sci. 2020 Dec 21;9(51):3881–6.
Di Saverio S, Podda M, De Simone B, Ceresoli M, Augustin G, Gori A, et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. Vol. 15, World Journal of Emergency Surgery. BioMed Central Ltd.; 2020.
Podda M, Pisanu A, Sartelli M, Coccolini F, Damaskos D, Augustin G, et al. Diagnosis of acute appendicitis based on clinical scores: Is it a myth or reality? Vol. 92, Acta Biomedica. Mattioli 1885; 2021.
Ohle R, O’Reilly F, O’Brien KK, Fahey T, Dimitrov BD. The Alvarado score for predicting acute appendicitis: A systematic review. BMC Med. 2011 Dec 28;9.
Krzyzak M, Mulrooney SM. Acute Appendicitis Review: Background, Epidemiology, Diagnosis, and Treatment. Cureus. 2020 Jun 11;
Bouali M, El Berni Y, Moufakkir A, El Bakouri A, El Hattabi K, Bensardi F, et al. Value of Alvarado scoring system in diagnosis of acute appendicitis. Annals of Medicine and Surgery. 2022 May 1;77.
Özsoy Z, Yenidoǧan E. Evaluation of the Alvarado scoring system in the management of acute appendicitis. Turk J Surg. 2017;33(3):200–4.
Kabir SA, Kabir SI, Sun R, Jafferbhoy S, Karim A. How to diagnose an acutely inflamed appendix; a systematic review of the latest evidence. Vol. 40, International Journal of Surgery. Elsevier Ltd; 2017. p. 155–62.
Tan WJ, Acharyya S, Chew MH, Foo FJ, Chan WH, Wong WK, et al. Randomized control trial comparing an Alvarado Score-based management algorithm and current best practice in the evaluation of suspected appendicitis. World Journal of Emergency Surgery. 2020 May 1;15(1).
Gonullu E, Bayhan Z, Capoglu R, Mantoglu B, Kamburoglu B, Harmantepe T, et al. Diagnostic Accuracy Rates of Appendicitis Scoring Systems for the Stratified Age Groups. Emerg Med Int. 2022 Oct 31; 2022:1–11.
Vaghela K, Shah B. Diagnosis of acute appendicitis using clinical Alvarado scoring system and computed tomography (CT) criteria in patients attending Gujarat Adani institute of medical science – a retrospective study. Pol J Radiol. 2017 Nov 17; 82:726–30.
Dey S, Mohanta PK, Baruah AK, Kharga B, Bhutia KL, Singh VK. Alvarado scoring in acute appendicitis-A clinicopathological correlation. Indian Journal of Surgery. 2010 Dec;72(4):290–3.
Capoglu R, Gonullu E, Bayhan Z, Coskun M, Harmantepe T, Kucuk F. Comparison of scoring systems regarding the gender as a parameter with the traditional scoring systems for predicting appendicitis. Updates Surg. 2022 Jun 1;74(3):1035–42.
Skjold-Ødegaard B, Søreide K. The Diagnostic Differentiation Challenge in Acute Appendicitis: How to Distinguish between Uncomplicated and Complicated Appendicitis in Adults. Vol. 12, Diagnostics. MDPI; 2022.
Nair N, Sagaran D, Sagaran K. Role of clinical scoring system and imaging in acute appendicitis in adults: a review of literature.
Naeem MT, Jamil MA, Anwar MI, Raza H, Asad A, Jamil H, et al. Diagnostic accuracy of Alvarado scoring system relative to histopathological diagnosis for acute appendicitis: A retrospective cohort study. Annals of Medicine and Surgery. 2022 Sep 1;81.
Shogilev DJ, Duus N, Odom SR, Shapiro NI. Diagnosing appendicitis: Evidence-based review of the diagnostic approach in 2014. Vol. 15, Western Journal of Emergency Medicine. eScholarship; 2014. p. 859–71.
Mán E, Simonka Z, Varga Á, Rárosi F, Lázár G. Impact of the alvarado score on the diagnosis of acute appendicitis: Comparing clinical judgment, alvarado score, and a new modified score in suspected appendicitis: A prospective, randomized clinical trial. Surg Endosc. 2014;28(8):2398–405.
Kinesya E, Cintya EP, Dorothy MJ, Ennaidi NN, Rusti HF, Mannagalli Y, et al. Diagnostic accuracy of Alvarado score components in patients with appendicitis: Systematic review and meta-analysis approach. Health Sciences Review. 2022 Mar; 2:100018.
Gupta S, Kolli VS, Da Costa K, Javed S, Ammar A, Rasheed A. A systematic review and meta-regression for validation of the Alvarado score as a tool for predicting acute appendicitis. Annals of Medicine & Surgery. 2023 Feb;85(2):111–21.
District General Hospital S, Talbot FRCS SD, Elizabeth Hospital Q. Evaluation of the modified Alvarado score in the diagnosis of acute appendicitis: a prospective study M Kalan MS FRCS FRCSEd A J Rich MD FRCS Registrar in General Surgery Consultant in General Surgery W J Cunliffe MD FRCS Consultant in General Surgery. Vol. 76, Ann R Coll Surg Engl. 1994.
Jain S, Gehlot A, Songra MC. Modified alvarado score in diagnosis of acute appendicitis: a clinicopathological study. International Surgery Journal. 2018 Feb 26;5(3):878.
Kanumba ES, Mabula JB, Rambau P, Chalya PL. Modified Alvarado Scoring System as a diagnostic tool for Acute Appendicitis at Bugando Medical Centre, Mwanza, Tanzania. BMC Surg. 2011;11.
Phophrom J, Trivej T. The Modified Alvarado Score Versus the Alvarado Score for the Diagnosis of Acute Appendicitis. Vol. 26, The THAI Journal of SURGERY. 2005.
Chee W, Chong F. Evaluation of the RIPASA Score: A new appendicitis scoring system for the diagnosis of acute appendicitis Evaluation of the RIPASA Score: a new scoring system for the diagnosis of acute appendicitis [Internet]. Article in Brunei International Medical Journal. 2010. Available from: https://www.researchgate.net/publication/47716251
Frountzas M, Stergios K, Kopsini D, Schizas D, Kontzoglou K, Toutouzas K. Alvarado or RIPASA score for diagnosis of acute appendicitis? A meta-analysis of randomized trials. Vol. 56, International Journal of Surgery. Elsevier Ltd; 2018. p. 307–14.
Favara G, Maugeri A, Barchitta M, Ventura A, Basile G, Agodi A. Comparison of RIPASA and ALVARADO scores for risk assessment of acute appendicitis: A systematic review and meta-analysis. Vol. 17, PLoS ONE. Public Library of Science; 2022.
Khan S, Usama M, Basir Y, Muhammad S, Jawad M, Khan T, et al. EVALUATION OF MODIFIED ALVARADO, RIPASA AND LINTULA SCORING SYSTEM AS DIAGNOSTIC TOOLS FOR ACUTE APPENDICITIS [Internet]. Vol. 32, J Ayub Med Coll Abbottabad. 2020. Available from: http://www.jamc.ayubmed.edu.pk46
Chisthi MM, Surendran A, Narayanan JT. RIPASA and air scoring systems are superior to alvarado scoring in acute appendicitis: Diagnostic accuracy study. Annals of Medicine and Surgery. 2020 Nov 1; 59:138–42.
Noor S, Wahab A, Afridi G, Ullah K. COMPARING RIPASA SCORE AND ALVARADO SCORE IN AN ACCURATE DIAGNOSIS OF ACUTE APPENDICITIS [Internet]. Vol. 32, J Ayub Med Coll Abbottabad. 2020. Available from: http://www.jamc.ayubmed.edu.pk38
Heiranizadeh N, Mousavi Beyuki SMH, kargar S, Abadiyan A, Mohammadi HR. Alvarado or RIPASA? Which one do you use to diagnose acute appendicitis? A cross-sectional study. Health Sci Rep. 2023 Jan 1;6(1).
Ashkan Tabibzadeh Dezfuli S, Yazdani R, Khorasani M, Alireza Hosseinikhah S. Comparison between the specificity and sensitivity of the RIPASA and Alvarado Scoring systems in the diagnosis of acute appendicitis among patients with complaints of right iliac fossa. AIMS Public Health [Internet]. 2019;7(1):1–9. Available from: http://www.aimspress.com/article/10.3934/publichealth.2020001
RIPASA Score: A New Diagnostic Score for Diagnosis of Acute Appendicitis [Internet]. 2014. Available from: https://www.researchgate.net/publication/269768825
Regar MK, Choudhary GS, Nogia C, Pipal DK, Agrawal A, Srivastava H. Comparison of Alvarado and RIPASA scoring systems in diagnosis of acute appendicitis and correlation with intraoperative and histopathological findings. International Surgery Journal. 2017 Apr 22;4(5):1755.
Chee Fui C, F CC, J A MA, S TA, A AM, T TL, et al. O r i g i n a l A r t i c l e Comparison of RIPASA and Alvarado scores for the diagnosis of acute appendicitis. Vol. 52, Singapore Med J. 2011.
Karami MY, Niakan H, Zadebagheri N, Mardani P, Shayan Z, Deilami I. Which one is better? Comparison of the acute inflammatory response, Raja Isteri Pengiran Anak Saleha Appendicitis and Alvarado scoring systems. Ann Coloproctol. 2017 Dec 1;33(6):227–31.
Zeb M, Khattak SK, Samad M, Shah SS, Shah SQA, Haseeb A. Comparison of Alvarado score, appendicitis inflammatory response score (AIR) and Raja Isteri Pengiran Anak Saleha appendicitis (RIPASA) score in predicting acute appendicitis. Heliyon. 2023 Jan 1;9(1).
Erdem H, Çetinkünar S, Daş K, Reyhan E, Deǧer C, Aziret M, et al. Alvarado, Eskelinen, Ohhmann and Raja Isteri Pengiran Anak Saleha appendicitis scores for diagnosis of acute appendicitis. World J Gastroenterol. 2013 Dec 21;19(47):9057–62.
Naeem MS, Sadiq Z, Awais M, Rafi M, Javeed S, Ahmed I, et al. Accuracy of RIPASA and Lintula Scores in Diagnosing Acute Appendicitis Using Surgical Findings as the Gold Standard. Cureus. 2022 Nov 9.
Andersson M, Kolodziej B, Andersson RE. Validation of the Appendicitis Inflammatory Response (AIR) Score. World J Surg. 2021 Jul 1;45(7):2081–91.
Von-Mühlen B, Franzon O, Beduschi MG, Kruel N, Lupselo D. AIR score assessment for acute appendicitis. Arq Bras Cir Dig. 2015 Jul 1;28(3):171–3.
Castro SMMD, Ünlü Ç, Steller EP, Van Wagensveld BA, Vrouenraets BC. Evaluation of the appendicitis inflammatory response score for patients with acute appendicitis. World J Surg. 2012;36(7):1540–5.
Gupta V, Gupta P, Gill C, Gupta M. Appendicitis inflammatory response score in acute appendicitis: A study at a tertiary care center in North India. Int J Appl Basic Med Res. 2022;12(4):234.
Deboni VS, Rosa MI, Lima AC, Graciano AJ, Garcia CE. THE APPENDICITIS INFLAMMATORY RESPONSE SCORE FOR ACUTE APPENDICITIS: IS IT IMPORTANT FOR EARLY DIAGNOSIS? Arquivos Brasileiros de Cirurgia Digestiva. 2022;35.
Jose T, Rajesh P. Appendicitis Inflammatory Response Score in Comparison to Alvarado Score in Acute Appendicitis. The Surgery Journal. 2021 Jul;07(03):e127–31.
Vaziri M, Nafissi N, Jahangiri F, Nasiri M. Comparison of the appendicitis inflammatory response and Alvarado scoring systems in the diagnosis of acute appendicitis in children. J Med Life. 2021;14(1):75–80.
Sammalkorpi HE, Mentula P, Savolainen H, Leppäniemi A. The Introduction of Adult Appendicitis Score Reduced Negative Appendectomy Rate. Scandinavian Journal of Surgery. 2017 Sep 1;106(3):196–201.
Sammalkorpi HE, Mentula P, Leppäniemi A. A new adult appendicitis score improves diagnostic accuracy of acute appendicitis - a prospective study. BMC Gastroenterol. 2014 Jun 26;14(1).
Raffaele P, Simona G, Giovanna M, Md P, Antonio C, Sergio G, et al. Acute Appendicitis: Correspondence Between Adult Appendicitis Score (AAS) and Intraoperative Survey as Assessed by the Questionnaire Obtained from the Laparoscopic Appendicitis Score (LAPP) in 102 Patients in a Single-Centre. Vol. 6, Journal of Medical-Clinical Research & Reviews ISSN 2639-944X.
Yılmaz EM, Kapçı M, Çelik S, Manoğlu B, Avcil M, Karacan E. Alvarado ve Ohmann skorlamaları apandisit tanısında ve enflamasyonun şiddetinde gerçek yol gösterici olabilir mi? Ulusal Travma ve Acil Cerrahi Dergisi. 2017 Jan 1;23(1):29–33.
Bharath NS, Anurag M, Srinivas L, Banothu G. ORIGINAL RESEARCH Evaluation of Ohmann Score in the Diagnosis of Acute Appendicitis in Patients Admitted in a Tertiary Care Hospital. Vol. 09, European Journal of Molecular & Clinical Medicine.
Yoldas O, Karaca T, Tez M. External validation of Lintula score in Turkish acute appendicitis patients. International Journal of Surgery. 2012;10(1):25–7.
Sitter H, Hoffmann S, Hassan I, Zielke A. Diagnostic score in appendicitis. Langenbecks Arch Surg. 2004 Jun;389(3).
Iftikhar MA, Dar SH, Rahman UA, Butt MJ, Sajjad M, Hayat U, et al. Comparison of Alvarado score and pediatric appendicitis score for clinical diagnosis of acute appendicitis in children—a prospective study. Annals of Pediatric Surgery. 2021 Dec 1;17(1).
Maaz Salahuddin S, Ayaz O, Jaffer M, Naeem R, Sundar Tikmani S, Mian AI, et al. Pediatric Appendicitis Score for Identifying Acute Appendicitis in Children Presenting with Acute Abdominal Pain to the Emergency Department. Vol. 774, INDIAN PEDIATRICS.