PT  - JOURNAL ARTICLE
AU  - ESKELINEN, MAARET
AU  - MEKLIN, JANNICA
AU  - SYRJÄNEN, KARI
AU  - ESKELINEN, MATTI
TI  - A Diagnostic Score (DS) Is a Powerful Tool in Diagnosis of Acute Appendicitis in Elderly Patients With Acute Abdominal Pain
AID  - 10.21873/anticanres.14904
DP  - 2021 Mar 01
TA  - Anticancer Research
PG  - 1459--1469
VI  - 41
IP  - 3
4099  - http://ar.iiarjournals.org/content/41/3/1459.short
4100  - http://ar.iiarjournals.org/content/41/3/1459.full
SO  - Anticancer Res2021 Mar 01; 41
AB  - Background/Aim: Although acute appendicitis (AA) in elderly patients is different from AA in younger patients, the accuracy of diagnostic scores (DSs) in detecting AA is rarely considered. Patients and Methods: A cohort of 470 AAP (acute abdominal pain) patients older than 50 years, including 224 women (53.7%) and 193 men (46.3%), were included in the study. The most significant diagnostic predictors were used to construct DS formulas for AA diagnosis with (Tax+) and without body temperature (Tax–). Meta-analytical techniques were used to calculate the summary Se and Sp estimates for each data sets (history-taking, findings, and DS formulas). Results: In SROC analysis, the AUC values for i) symptoms ii) signs and tests iii) DSTax– and iv) DSTax+ were as follows: i) AUC=0.658 (95%CI=0.601-0.709); ii) AUC=0.751 (95%CI=0.701-0.800), iii) AUC=0.977 (95%CI=0.942-1.000), and for iv) AUC=0.980 (95%CI=0.956-1.000). Using roccomp analysis for these AUC values, the differences were significant as follows: between i) and ii) p=0.0358; between i) and iii) p<0.0001; between i) and iv) p<0.0001; between ii) and iii) p<0.0001; between ii) and iv) p<0.0001; and between iii) and iv) p=0.682. Conclusion: Similar to younger AA patients, the DS formula was superior to both the clinical history-taking and findings, and therefore, the use of DS should be an important part of the diagnostic decision tree of AA also in the elderly patients presenting with AAP.