Table 1.
Parameters and scores in each clinical scoring system
| Parameter | Proposed score |
||||
|---|---|---|---|---|---|
| Alvarado | Eskelinen | AIR | RIPASA | AAS | |
| Demographics | |||||
| Male | - | - | - | 1.0 | - |
| Female | - | - | - | 0.5 | - |
| Age (yr) | |||||
| < 40 | - | - | - | 1.0 | - |
| ≥ 40 | - | - | - | 0.5 | - |
| Foreign national registration ID card | - | - | - | 1.0 | - |
| Symptoms | |||||
| Nausea/vomiting | 1 | - | - | 1.0 | - |
| Vomiting | - | - | 1 | - | - |
| Anorexia | 1 | - | - | 1.0 | - |
| RIF pain | - | 3.51 | 1 | 0.5 | 2 |
| Migratory pain to the RIF | 1 | - | - | 0.5 | 2 |
| Duration of pain (hr) | |||||
| < 48 | - | - | - | 1.0 | - |
| ≥ 48 | - | 2.13 | - | 0.5 | - |
| Signs | |||||
| RIF tenderness | 2 | 11.41 | - | 1.0 | 3/1a) |
| Rebound tenderness | 1 | 4.25 | - | 1.0 | - |
| Muscular defense/rebound | 6.62 | 2.0 | |||
| Mild | - | - | 1 | - | 2 |
| Intermediate | - | - | 2 | - | 4 |
| Strong | - | - | 3 | - | 4 |
| Temperature (°C) | |||||
| ≥ 37.3 | 1 | - | - | 1.0b) | - |
| ≥ 38.5 | - | - | 1 | - | - |
| Rovsing’s sign | - | - | - | 2.0 | - |
| Clinical results | |||||
| White blood cell count (× 109/L) | |||||
| ≥ 10.0 | 2 | 5.88 | 1 | 1.0b) | - |
| ≥ 7.2 and < 10.9 | - | - | - | - | 1 |
| ≥ 10.9 and < 14.0 | - | - | - | - | 2 |
| ≥ 14.0 | - | - | - | - | 3 |
| ≥ 15.0 | - | - | 2 | - | - |
| Polymorphonuclear leukocytes (%) | |||||
| > 75 | 1 | - | - | - | - |
| ≥ 70 and < 85 | - | - | 1 | - | - |
| ≥ 85 | - | - | 2 | - | - |
| ≥ 62 and < 75 | - | - | - | - | 2 |
| ≥ 75 and < 83 | - | - | - | - | 3 |
| ≥ 83 | - | - | - | - | 4 |
| C-reactive protein concentration (mg/L) | |||||
| ≥ 10 and < 50 | - | - | 1 | - | - |
| ≥ 50 | - | - | 2 | - | - |
| ≥ 4 and < 11 (< 24-hour symptoms) | - | - | - | 2 | |
| ≥ 11 and < 25 (< 24-hour symptoms) | - | - | - | 3 | |
| ≥ 25 and < 83 (< 24-hour symptoms) | - | - | - | 5 | |
| ≥ 83 (< 24-hour symptoms) | - | - | - | 1 | |
| ≥ 12 and < 53 (≥ 24-hour symptoms) | - | - | - | 2 | |
| ≥ 53 and < 152 (≥ 24-hour symptoms) | - | - | - | 2 | |
| ≥ 152 (≥ 24-hour symptoms) | - | - | - | 1 | |
| Negative urinalysis | - | - | - | 1.0 | - |
| Total or maximum score | 10 | 67.60 | 12 | 16.0 | 25 |
The variables which were not included in each clinical scoring system were marked as ‘-’.
AIR, appendicitis inflammatory response; RIPASA, Raja Isteri Pengiran Anak Saleha Appendicitis; AAS, adult appendicitis score; RIF, right iliac fossa.
a)
Men and women older than 50 years/women aged 16 to 49 years.
b)
The criteria for fever and elevated white blood cells have not been fully established in previous studies using the RIPASA score. Therefore, the score was evaluated using the criteria of our institution.