External validation of the AppendistatTM score and comparison with CRP levels for the prediction of complicated appendicitis

BACKGROUND: In acute appendicitis, the treatment approach may vary depending on the age and comorbidities of the patient and whether the appendix is complicated. In this study, we validated the appendistatTM score, including the logistic regression model of complicated appendicitis, and compared the efficacy of this scoring with C-reactive protein in predicting complicated appendicitis.
METHODS: Demographic characteristics, pathology, and laboratory results of patients who underwent appendectomy for acute appendicitis were retrospectively screened, those over 18 years of age were included in the study. The appendistatTM scores, including the logistic regression model of complicated appendicitis, were obtained.
RESULTS: Complicated appendicitis was present in 13 (10.1%) patients and non-complicated appendicitis in 116 (89.9%). Two (15.4%) of the complicated appendicitis cases were female and 11 (84.6%) were male. The mean age of complicated appendicitis cases was 44 (20–77) years, and their median value of C-reactive protein was 41.00 mg/L. In the ROC curve analysis, the cut-off value for C-reactive protein was 23.5 mg/L and that of the appendistatTM as 9.6. The area under the curve values of the appendistatTM score and C-reactive protein were 0.787 and 0.750, respectively.
CONCLUSION: AppendistatTM is a successful scoring system that contains appropriate parameters. However, C-reactive protein detecting or excluding complicated appendicitis at a similar rate to AppendistatTM suggests that the latter does not have a significant advantage in clinical practice.

AppendistatTM skoru doðrulamasý ve komplike apandisitleri ön görmede CRP düzeyleriyle karþýlaþtýrýlmasý

AMAÇ: Akut apandisitlerde hastanýn yaþý, komorbiditesi ve apendiksin komplike olup olmamasýna göre hastaya uygulanacak tedavi yaklaþýmý deðiþebilir. Bu çalýþmada, komplike apandisit lojistik regresyon modelini içeren AppendistatTM skorunun doðrulamasýný yapýp ayný zamanda appendistatTM skoru ile C-reaktif protein’in komplike apendisitleri ön görmedeki etkinliðini karþýlaþtýrdýk.
GEREÇ VE YÖNTEM: Akut apandisit nedeniyle hastanemizde apendektomi yapýlan hastalarýn demografik özellikleri, patoloji ve laboratuvar sonuçlarý geriye dönük olarak tarandý. On sekiz yaþ üzeri apendektomi yapýlan hastalar çalýþmaya dahil edildi. Komplike apandisit lojistik regresyon modelini içeren AppendistatTM skoru kullanýldý.
BULGULAR: On üç (%10.1) hastada komplike ve 116 (%89.9) hastada non-komplike apandisit izlendi. Komplike apandisitlerin 2’si (%15.4) kadýn 11’i (%84.6) erkekti. Komplike apandisitlerin yaþ ortalamasý 44 (20–77) yýl ve C-reaktif protein’in median deðeri 41.00 mg/L idi. ROC eðri analizinde c-reaktif protein için kestirim deðeri 23.5mg/L olarak bulundu. AppendistatTM skoru için kestirim deðeri 9.6 olarak bulundu. AppendistatTM skoru ve C-reaktif protein’in Area Under the Curve’ü sýrasýyla 0.787/0.750 idi.
TARTIÞMA: AppendistatTM skoru doðru parametreleri içeren baþarýlý bir skorlama sistemidir. C-reaktif protein parametresinin de komplike apandisitleri benzer oranda belirleyebilmesi ya da dýþlayabilmesi göz önüne alýndýðýnda; klinik uygulamada bu skorlama sisteminin belirgin üstünlüðü olmadýðýný düþündürmektedir.