Development and validation of a risk score predicting acute uncomplicated appendicitis

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Published May 1, 2025
https://doi.org/10.62438/tunismed.v103i5.5727
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Vol. 103 No. 5 (2025): Tunis Med May 2025

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Amine Ben Safta
Department B of General Surgery – Charles Nicolle’s Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunisia
Imen Samaali
Department B of General Surgery – Charles Nicolle’s Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunisia
Chadli Dziri
Department B of General Surgery – Charles Nicolle’s Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunisia
Neirouz Kammoun
Department B of General Surgery – Charles Nicolle’s Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunisia
Salsabil Nasri
Department B of General Surgery – Charles Nicolle’s Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunisia
Ramzi Nouira
Department B of General Surgery – Charles Nicolle’s Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunisia

Abstract

Introduction-Aim: Acute appendicitis (AA) is the most frequent emergency among non-traumatic abdominal emergencies. The aim of this study was to identify independent predictive factors for acute uncomplicated appendicitis (UCAA) and to define a predictive score.


Methods: A retrospective study was conducted in the surgical department B of Charles Nicolle’s Hospital of Tunis from January 1, 2013 to December 31, 2014. All consecutive patients operated on for AA were included. The diagnosis was confirmed by operative findings, macroscopic and histological examination of the removed appendix. Complicated acute appendicitis (CAA) was defined by the intraoperative findings of an appendicular abscess or generalized peritonitis. The Score was developed based on a logistic regression to identify the independent and predictive factors among the pre, intra and postoperative variables.


Results: This study (335 patients) allowed us to identify the independent factors predictive of CAA, i.e. the duration of pain evolution in the right lower quadrant (OR = 1,444; 95% IC = [1,204 - 1.725]; p < 10-3), guarding of the right lower quadrant (OR = 2.234; 95% CI = [1.051 - 4.749]; p = 0.037) and CRP > 86,8 mg/l (OR = 1.012; 95% CI = [1.008 - 1.016]; p < 10-3). The area under the curve of the score was 0.884 with a 95% CI [0.837 - 0.980]; p < 0.001. This score was validated on a sample of 236 patients culled between January 1, 2015 to May 16, 2016.


Conclusion: Patients admitted for AA with a duration ..(abstract truncated at 250 words).

Keywords:

Acute Appendicitis, complicated acute appendicitis, Uncomplicated acute appendicitis, prognosis, predictive variables, predictive score

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