Ulus Travma Acil Cerrahi Derg. 2018; 24(6): 557-562 | DOI: 10.5505/tjtes.2018.72318

Alvarado ve Apandisit Ýnflamatuar Yanýt Skorlamalarý Akut Apandisitin Þiddetini Deðerlendirebilir mi?

Metin Yeþiltaþ, Dursun Özgür Karakaþ, Berk Gökçek, Semih Hot, Seracettin Eðin
Okmeydaný Eðitim Ve Araþtýrma Hastanesi, Genel Cerrahi Servisi, Ýstanbul, Türkiye

Giriþ: Alvarado (AS) and Apandisit Ýnflamatuar Yanýt (AIYS) skorlarý akut apandisit (AA) tanýsý için geliþtirilmiþ skorlardýr. Bu çalýþmanýn amacý AA þiddetinin AS ve AIYS ile deðerlendirmesidir.
Materyal ve Metot: Ocak 2016-Aralýk 2017 tarihleri arasýnda AA nedeni ile opere edilen ve preop AS ve AIYS yapýlan hastalar geriye dönük deðerlendirildi. Yaþ, cinsiyet, patolojik þiddet, lokal peritonit, fekaloid, drenaj, apendix çapý ve operasyon þekli AS ve AIYS göre deðerlendirildi.
Bulgular: 578 hasta çalýþmaya dâhil edildi. Apandisit %44,4 ile en sýk görülen patolojiydi. En sýk ölçülen apandiks çapý ise %59,2 ile 7-10 mm idi. Bütün patolojiler arasýndaki AS ve AIYS istatistiksel olarak anlamlý bulundu (p<0,05). Komplike ve komplike olmayan apandisitler arasýndaki sadece AIYS istatistiksel olarak anlamlý bulundu (p<0,05). Apandiks çaplarý arasýndaki sadece AIYS istatistiksel olarak anlamlý bulundu (p<0,05). Drenaj yapýlan hastalarda AS ve AIYS istatistiksel olarak anlamlý farklýlýk saptandý (p<0,05). AS ile patolojik þiddet, lokal peritonit ve drenajýn korelasyonu, AIYS ile patolojik þiddet, komplike/ komplike olmayan, apandiks çapý ve drenajýn korelasyonu istatistiksel olarak anlamlý bulundu (p<0,05).
Sonuç: AS ve AIYS her ikisi de patolojik þiddeti deðerlendirebilmekte iken sadece AIYS komplike ve komplike olmayan apandisitleri, apandiks çapýnýn daha anlamlý deðerlendirebilmektedir. Bu skorlarý kullanarak gereksiz radyolojik ve cerrahi giriþimlerini azaltabilecektir.

Anahtar Kelimeler: Akut apandisit, Alvarado Skoru, Apandisit Ýnflamatuar Yanýt Skoru, Patoloji, Drenaj, Lokal peritonit

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Can Alvarado and Appendicitis Inflammatory Response scores evaluate the severity of acute appendicitis?

Metin Yeþiltaþ, Dursun Özgür Karakaþ, Berk Gökçek, Semih Hot, Seracettin Eðin
Department of General Surgery, Okmeydaný Training and Research Hospital, Ýstanbul-Turkey

BACKGROUND: The Alvarado score (AS) and the Appendicitis Inflammatory Response score (AIRS) were developed to diagnose acute appendicitis (AA). The aim of this study was to evaluate the severity of AA using the AS and the AIRS tools.
METHODS: Patients who presented between January 2016 and December 2017 and underwent surgery for AA and who had a preoperative AS and AIRS value were evaluated retrospectively. The details of age, sex, pathological severity, the presence of local peritonitis or fecaloid, drainage, appendix diameter, and operation type were evaluated according to the AS and the AIRS.
RESULTS: A total of 578 patients were included in the study. Appendicitis was the most common pathological severity classification (44.4%). The most common appendix diameter group was 7–10 mm (59.2%). The difference observed in the AS and AIRS results for all of the pathological severity categories was statistically significant (p<0.05). The AIRS revealed a statistically significant difference (p<0.05) in the detection of uncomplicated and complicated appendicitis. The AIRS difference was statistically significant for appendix diameter (p<0.05). The AS and the AIRS results were both statistically significant for drainage (p<0.05). The AS was correlated with pathological severity, local peritonitis, and drainage, while the AIRS was correlated with pathological severity, uncomplicated/complicated determination, appendix diameter, and drainage (p<0.05).
CONCLUSION: Both the AS and the AIRS can evaluate pathological severity, but only the AIRS can evaluate complicated or uncomplicated appendicitis and the diameter of the appendix. These tools can be used to reduce the number of unnecessary radiological or surgical interventions.

Keywords: Acute appendicitis, Alvarado score; Appendicitis Inflammatory Response score; drainage; local peritonitis; pathology

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