Table 2.
Comparison of the most popular and validated clinical scores for the diagnosis of AA
| Alvarado scorea | AIR scoreb | PAS scorec | RIPASA scored | AAS scoree | |
|---|---|---|---|---|---|
| Vomiting | 1 | ||||
| Nausea or vomiting | 1 | 1 | 1 | ||
| Anorexia | 1 | 1 | 1 | ||
| Pain in RIFf | 2 | 1 | 0.5 | 2 | |
| Migration of pain to the RIFf | 1 | 1 | 0.5 | 2 | |
| Rovsing’s sign | 2 | ||||
| RIFg tenderness | 2 | 1 | |||
| Women >50 years or men (any age) | 3 | ||||
| Women <50 years | 1 | ||||
| Rebound tenderness or muscular defense/guarding | 1 | 1 + 2 | |||
| Light | 1 | 2 | |||
| Medium | 2 | 4 | |||
| Strong | 3 | 4 | |||
| Body temperature | |||||
| > 37.5 °C | 1 | 1 | |||
| > 38.5 °C | 1 | ||||
| > 37– <39 °C | 1 | ||||
| WBC (white blood cell) count | |||||
| > 10.0 × 109/l | 2 | 1 | 1 | ||
| 10.0–14.9 × 109/l | 1 | ||||
| ≥ 15.0 × 109/l | 2 | ||||
| ≥ .2 and <10.9 × 109/l | 1 | ||||
| ≥ 10.9 and <14.0 × 109/l | 2 | ||||
| ≥ 14.0 × 109/l | 3 | ||||
| Leukocytosis shift | 1 | ||||
| Polymorphonuclear leukocytes | |||||
| 70–84 % | 1 | ||||
| ≥ 75 % | 1 | ||||
| ≥ 85 % | 2 | ||||
| ≥ 62 % and < 75 % | 2 | ||||
| ≥ 75 % and < 83 % | 3 | ||||
| ≥ 83 % | 4 | ||||
| CRP (C-reactive protein) concentration | |||||
| 10–49 mg/l | 1 | ||||
| ≥ 50 mg/l | 2 | ||||
| Symptoms <24 h and CRP (C-reactive protein) concentration | |||||
| ≥ 4 and <11 mg/l | 2 | ||||
| ≥ 11 and <25 mg/l | 3 | ||||
| ≥ 25 and <83 mg/l | 5 | ||||
| ≥ 83 mg/l | 1 | ||||
| Symptoms >24 h and CRP (C-reactive protein) concentration | |||||
| ≥ 12 and <53 mg/l | 2 | ||||
| ≥ 53 and <152 mg/l | 2 | ||||
| ≥ 152 mg/l | 1 | ||||
| Coughing/hopping/percussion pain | 2 | ||||
| Gender | |||||
| Male | 1 | ||||
| Female | 0.5 | ||||
| Age | |||||
| < 40 years | 1 | ||||
| ≥ 40 years | 0.5 | ||||
| Duration of symptoms | |||||
| < 48 h | 1 | ||||
| > 48 h | 0.5 | ||||
| Negative urinalysis | 1 | ||||
| Total score | 10 | 12 | 10 | 16.5 | 23 |
aAlvarado score: sum 0–4 = not likely appendicitis, sum 5–6 = equivocal, sum 7–8 = probably appendicitis, sum 9–10 = highly likely appendicitis
bAcute appendicitis response score (AIR): sum 0–4 = low probability, sum 5–8 = indeterminate group, sum 9–12 = high probability [161]
cPediatric appendicitis score (PAS): ≥6 = appendicitis, ≤5 = observe
dRaja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score
eAdult Appendicitis Score (AAS): low risk (0–10 points), intermediate risk (11–15 points), high risk (≥16 points)
f right iliac fossa