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JOURNAL OF MEDICAL AND SURGICAL RESEARCH - Vol. VIII, n 1, June 2021

Pages: 966-972
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The Bedel Score: Suggesting a New Scoring System to Avoid Negative Appendectomy

Author: Cihan Bedel, Mustafa Korkut, Fatih Selvi, Ökkes Zortuk

Category: JMSR Surgery

Abstract:

Introduction: Scoring systems are still valuable and valid for differential diagnosis of acute appendicitis (AA). Bedel Score is a new diagnostic tool with 7 parameters that can be easily applied. The aim of this study is to determine the diagnostic performance of the Bedel score in AA and compare it with the Alvarado score. Methods: Our study consisted of 95 patients as a prospective cohort who were admitted to our emergency department due to abdominal pain and were hospitalized with a preliminary diagnosis of AA. Bedel and Alvarado scores were calculated. The patients were categorized into two groups (positive and negative appendectomy) according to their histopathological diagnosis. Results: The study population consisted of 65 (68.4%) male and 30 (31.6%) female patients. The mean age of the patients was 34 (18-87) years. 81 (85.3%) of the patients had histopathologically confirmed AA. Median Alvarado score was significantly higher in patients with positive AA than those with negative AA (7 (range: 3-10) vs. 5 (range 3-7), p<0.001, respectively). Median Bedel score of positive AA patients were also significantly higher than those with negative AA (9 (range: 6-10) vs. 5 (range 2-8) p<0.001, respectively) In separating acute appendicitis from negative exploration, the threshold of the Alvarado score is 63% sensitivity for ?7, 85.7% specificity; The Bedel score had 80.2% sensitivity and 92.9% specificity for the threshold value ?7. Conclusion: Bedel score is fast, simple, easy to learn and apply, as well as an effective and practical scoring system with only 7 parameters.

Keywords: Acute appendicitis, Alvarado score, New score, Negative appendectomy

DOI: 10.46327/msrjg.1.000000000000198

DOI URL: https://doi.org/10.46327/msrjg.1.000000000000198

References:

  1. Rathod S, Ali I, Bawa APS, Singh G, Mishra S, Nongmaithem M. Evaluation of raja isteri pengiran anak saleha appendicitis score: a new appendicitis scoring system. Med J DY Patil Vidyapeeth. 2015; 8(6):744. https://doi.org/10.4103/0975-2870.169914.
  2. Al-Abed YA, Alobaid N, Myint F. Diagnostic markers in acute appendicitis. Am J Surg. 2015;209 (6):1043-7. https://doi.org/10.1016/j.amjsurg.2014.05.024
  3. Parekh, D., Jain, D., Mohite, S. Phalgune D. Comparison of Outer Diameter of Appendix, C-reactive Protein, and Serum Bilirubin Levels in Complicated Versus Uncomplicated Appendicitis. Indian J Surg. 2019; 1-5. https://doi.org/10.1007/s12262-019-01931-2
  4. Lakshminarasimhaiah AKS, Nagaraja A, Srinivasaiah M Evaluation of Tzanakis scoring system in acute appendicitis: a prospective study. Int Surg. 2017; 4(10):3338-43. https://doi.org/10.18203/2349-2902.isj20174173
  5. Andersson M, Andersson RE .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. https://doi.org/ 10.1007/s00268-008-9649-y.
  6. Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg. Med 1986;15(5):557-64. https://doi.org/ 10.1016/s0196-0644(86)80993-3.
  7. Debnath J, George R, Ravikumar R. Imaging in acute appendicitis: What, when, and why? Armed Forces Med J India. 2017;73(1):74-9. https://doi.org/ 10.1016/j.mjafi.2016.02.005.
  8. Erdem H, Çetinkünar S, Da? K, Reyhan E, De?er C, Aziret M, et al. Alvarado, Eskelinen, Ohhmann and Raja Isteri Pengiran Anak Saleha appendicitis scores for diagnosis of acute appendicitis. World J Gastroenterol. 2013;19(47): 9057–62. https://doi.org/ 10.3748/wjg.v19.i47.9057
  9. Park JS, Jeong JH, Lee JI, Lee JH, Park JK, Moon HJ. Accuracies of diagnostic methods for acute appendicitis. Am Surg. 2013;79(1):101-6.
  10. Reddy MG, Reddy VM. Raja Isteri Pengiran Anak Saleha Appendicitis score for the diagnosis of acute appendicitis in comparison with the Alvarado score. Int Surg. 2020;7(2):459-64. https://doi.org/ 10.18203/2349-2902.isj20200298
  11. Bates MF, Khander A, Steigman SA, Tracy TF, Luks FI. Use of white blood cell count and negative appendectomy rate. Pediatrics. 2014;133(1):39-44. https://doi.org/ 10.1542/peds.2013-2418.
  12. Yang HR, Wang YC, Chung PK, Chen WK, Jeng LB, Chen RJ. Laboratory tests in patients with acute appendicitis. ANZ J Surg. 2006; 76(1?2):71-4. https://doi.org/ 10.1111/j.1445-2197.2006.03645.x.
  13. Huang Y, Xiao J, Cai T, Yang L, Shi F, Wang Y, et al .Immature granulocytes: a novel biomarker of acute respiratory distress syndrome in patients with acute pancreatitis. Journal of critical care 2019;50:303-8. https://doi.org/ 10.1016/j.jcrc.2018.12.002
  14. Patel P, Gadani R. Evaluation Of Ripasa Score For Acute Appendicitis: A New Diagnostic Scoring System. Paripex Indian J Res 2019;8(11):27-28.
  15. Kumar PS, Karthik P, Rawat Karan R. Determination of sensitivity and specificity of modified alvarado score and ultrasonography in patients with acute appendicitis. International Journal of Scientific Research. 2020;8:12. https://doi.org/ 10.36106/ijsr
  16. Cardall T, Glasser J, Guss DA. Clinical value of the total white blood cell count and temperature in the evaluation of patients with suspected appendicitis. Acad Emerg Med 2004;11(10):1021-7. https://doi.org/ 10.1197/j.aem.2004.04.011.
  17. Chong C, Thien A, Mackie A, Tin A, Tripathi S, Ahmad M, et al. Comparison of RIPASA and Alvarado scores for the diagnosis of acute appendicitis. Singapore Med J 2011;52(5):340-5.
  18. Nanjundaiah N, Mohammed A, Shanbhag V, Ashfaque K, Priya SA. Comparative study of RIPASA score and ALVARADO score in the diagnosis of acute appendicitis. J Clin Diagn Res 2014;8(11): NC03–NC05. https://doi.org/ 10.7860/JCDR/2014/9055.5170
  19. Kanumba ES, Mabula JB, Rambau P, Chalya PL. Modified Alvarado scoring system as a diagnostic tool for acute appendicitis at Bugando Medical Centre, Mwanza, Tanzania. BMC surgery 2011;11(1):4. https://doi.org/ 10.1186/1471-2482-11-4
  20. Oyetunji TA, Onguti SK, Bolorunduro OB, Cornwell III EE, Nwomeh BC. Pediatric negative appendectomy rate: trend, predictors, and differentials. Journal of Surgical Research 2012; 173(1):16-20. https://doi.org/ 10.1016/j.jss.2011.04.046.
  21. Karaman K, Ercan M, Demir H, Yalk?n Ö, Uzuno?lu Y, Gündo?du K, et al. The Karaman score: A new diagnostic score for acute appendicitis. Ulus Travma Acil Cerrahi Derg 2018; 24(6):545-51. https://doi.org/10.5505/tjtes.2018.62436
  22. Xu Y, Jeffrey RB, DiMaio MA, Olcott EW. Lymphoid hyperplasia of the appendix: a potential pitfall in the sonographic diagnosis of appendicitis. American Journal of Roentgenology 2016; 206(1):189-94. https://doi.org/ 10.2214/AJR.15.14846