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.