Comparative Diagnostic Accuracy of Appendicitis Inflammatory Response and Alvarado Scores in Adult Appendicitis

Background Acute appendicitis is a common surgical emergency, with diagnostic challenges that can lead to unnecessary surgeries. This study aims to compare the diagnostic accuracy of the Appendicitis Inflammatory Response (AIR) score and the Alvarado score in a clinical setting, examining the influe...

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Main Authors: Sawsan Hanafi, Noura Alshareef, Wesam Edrees, Jamil M. Baljoon, Faris Salah Abunar
Format: Article
Language:English
Published: Discover STM Publishing Ltd 2025-03-01
Series:Saudi Journal of Emergency Medicine
Subjects:
Online Access:https://sjemed.com/?mno=201077
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author Sawsan Hanafi
Noura Alshareef
Wesam Edrees
Jamil M. Baljoon
Faris Salah Abunar
author_facet Sawsan Hanafi
Noura Alshareef
Wesam Edrees
Jamil M. Baljoon
Faris Salah Abunar
author_sort Sawsan Hanafi
collection DOAJ
description Background Acute appendicitis is a common surgical emergency, with diagnostic challenges that can lead to unnecessary surgeries. This study aims to compare the diagnostic accuracy of the Appendicitis Inflammatory Response (AIR) score and the Alvarado score in a clinical setting, examining the influence of demographic variables on their performance. Methods A retrospective analysis was conducted on 166 patients at National Guard Health Affairs Hospital, Saudi Arabia, from May 2016 to April 2022. Patients were categorized into two groups: 83 with appendicitis and 83 with acute abdominal symptoms but without appendicitis. We evaluated the diagnostic accuracy of the AIR and Alvarado scores through risk probability of developing appendicitis, sensitivity, and specificity. We also examined the effects of age and gender on the scores' accuracy. Results The AIR score demonstrated higher overall sensitivity (95.7%) and specificity (90.5%) than the Alvarado score, which showed a sensitivity of 87.3% and a specificity of 52.4%. The AIR score was particularly effective in identifying patients with a high probability of appendicitis. Subgroup analysis revealed significant demographic influences, with men showing higher incidence rates of appendicitis and age impacting the scoring accuracy than women. Conclusions Our study's findings advocate for the AIR score's expanded use in clinical practice to improve diagnostic accuracy and patient management tailored to demographic variations. Further validation in varied clinical settings and larger cohorts is recommended. [SJEMed 2025; 6(1.000): 021-026]
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spelling doaj-art-f23eb15a2fb54203ac2d4fbe9f88c0dc2025-08-20T02:40:29ZengDiscover STM Publishing LtdSaudi Journal of Emergency Medicine1658-84872025-03-016102102610.24911/SJEMed.72-1715278407201077Comparative Diagnostic Accuracy of Appendicitis Inflammatory Response and Alvarado Scores in Adult AppendicitisSawsan Hanafi0Noura Alshareef1Wesam Edrees2Jamil M. Baljoon3Faris Salah Abunar4Emergency Department, Ministry of National Guard-Health Affairs, Jeddah, Saudi Arabia, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia Quality Management Department, Ministry of National Guard-Health Affairs, Saudi Arabia Emergency Department, Ministry of National Guard-Health Affairs, Jeddah, Saudi Arabia, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia Emergency Department, Ministry of National Guard-Health Affairs, Jeddah, Saudi Arabia, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia King Abdullah International Medical Research Center, Jeddah, Saudi Arabia, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi ArabiaBackground Acute appendicitis is a common surgical emergency, with diagnostic challenges that can lead to unnecessary surgeries. This study aims to compare the diagnostic accuracy of the Appendicitis Inflammatory Response (AIR) score and the Alvarado score in a clinical setting, examining the influence of demographic variables on their performance. Methods A retrospective analysis was conducted on 166 patients at National Guard Health Affairs Hospital, Saudi Arabia, from May 2016 to April 2022. Patients were categorized into two groups: 83 with appendicitis and 83 with acute abdominal symptoms but without appendicitis. We evaluated the diagnostic accuracy of the AIR and Alvarado scores through risk probability of developing appendicitis, sensitivity, and specificity. We also examined the effects of age and gender on the scores' accuracy. Results The AIR score demonstrated higher overall sensitivity (95.7%) and specificity (90.5%) than the Alvarado score, which showed a sensitivity of 87.3% and a specificity of 52.4%. The AIR score was particularly effective in identifying patients with a high probability of appendicitis. Subgroup analysis revealed significant demographic influences, with men showing higher incidence rates of appendicitis and age impacting the scoring accuracy than women. Conclusions Our study's findings advocate for the AIR score's expanded use in clinical practice to improve diagnostic accuracy and patient management tailored to demographic variations. Further validation in varied clinical settings and larger cohorts is recommended. [SJEMed 2025; 6(1.000): 021-026]https://sjemed.com/?mno=201077keywords: appendicitisdiagnosisair scorealvarado score
spellingShingle Sawsan Hanafi
Noura Alshareef
Wesam Edrees
Jamil M. Baljoon
Faris Salah Abunar
Comparative Diagnostic Accuracy of Appendicitis Inflammatory Response and Alvarado Scores in Adult Appendicitis
Saudi Journal of Emergency Medicine
keywords: appendicitis
diagnosis
air score
alvarado score
title Comparative Diagnostic Accuracy of Appendicitis Inflammatory Response and Alvarado Scores in Adult Appendicitis
title_full Comparative Diagnostic Accuracy of Appendicitis Inflammatory Response and Alvarado Scores in Adult Appendicitis
title_fullStr Comparative Diagnostic Accuracy of Appendicitis Inflammatory Response and Alvarado Scores in Adult Appendicitis
title_full_unstemmed Comparative Diagnostic Accuracy of Appendicitis Inflammatory Response and Alvarado Scores in Adult Appendicitis
title_short Comparative Diagnostic Accuracy of Appendicitis Inflammatory Response and Alvarado Scores in Adult Appendicitis
title_sort comparative diagnostic accuracy of appendicitis inflammatory response and alvarado scores in adult appendicitis
topic keywords: appendicitis
diagnosis
air score
alvarado score
url https://sjemed.com/?mno=201077
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AT wesamedrees comparativediagnosticaccuracyofappendicitisinflammatoryresponseandalvaradoscoresinadultappendicitis
AT jamilmbaljoon comparativediagnosticaccuracyofappendicitisinflammatoryresponseandalvaradoscoresinadultappendicitis
AT farissalahabunar comparativediagnosticaccuracyofappendicitisinflammatoryresponseandalvaradoscoresinadultappendicitis