Improvement in the Diagnosis of Appendicitis

. Author manuscript; available in PMC: 2014 Oct 30.

Published in final edited form as: Adv Surg. 2013;47:299–328. doi: 10.1016/j.yasu.2013.03.003

Variable	Level	Score
Pain or tenderness in RLQ		+1
Vomiting		+1
Rebound tenderness or muscular defense	Slight	+1
	Moderate	+2
	Strong	+3
WBC count	10–14.9 × 10⁹/L	+1
	≥15.0 × 10⁹/L	+2
Proportion neutrophils	70%–84%	+1
	≥85%	+2
CRP concentration	10–49 mg/L	+1
	≥50	+2
Body temperature	≥38.5 °C	+1

Summation of points

0–4 = low probability for appendicitis; outpatient follow-up if unaltered general condition

5–8 = indeterminate; in-hospital active observation with rescoring, imaging, or diagnostic laparoscopy according to local practice

9–12 = high probability for appendicitis; surgical exploration recommended

Adapted from Andersson M, Andersson R. The appendicitis inflammatory response score: a tool for the diagnosis of acute appendicitis that outperforms the Alvarado score. World J Surg 2008;32(8):1843–9; with permission.