Validation and Comparison of the Appendicitis Inflammatory Response Score and Adult Appendicitis Score

Study Overview
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Brief Summary
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Acute appendicitis is one of the most frequent reasons of emergency laparotomy in adults. Symptoms of acute appendicitis overlap with other clinical conditions and might present as a challenge, especially in the early phases. Despite the advances and widespread use of imaging modalities, still negative laparotomies are performed with the initial diagnosis of acute appendicitis. Several scoring systems are developed by using various clinical and laboratory parameters in order to improve the diagnostic accuracy and prevent unnecessary laparotomies.

Detailed Description
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In the recent guideline of World Society of Emergency Surgeons (WSES) recommendations regarding the clinical scoring systems for acute appendicitis are remarkable. It is stated that clinical scoring systems, on their own, can be used to exclude acute appendicitis and decrease negative laparotomy rates. Currently Appendicitis Inflammatory Response Score (AIR) and Adult Appendicitis Score (AAS) are the best clinically performing scoring systems. As a result, based on strong evidence the use of these two systems are recommended. Both scoring systems are developed on the basis of clinical findings and laboratory parameters. The aim of this study is to validate both systems as well as to compare the efficiency of both systems on excluding negative laparotomies and on the determination of severity of acute appendicitis.

Official Title
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Prospective Clinical Trial on Validation and Comparison of the Diagnostic and Prognostic Value of Appendicitis Inflammatory Response Score and Adult Appendicitis Score

Conditions
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Acute Appendicitis, Acute Appendicitis With Rupture

Intervention / Treatment
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* Diagnostic Test: Appendicitis Inflammatory Response
* Diagnostic Test: Adult Appendicitis Score


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Presenting to ER with right lower quadrant pain Patients between 18-65 years old. Exclusion Criteria: Patients receiving immun-suppressive therapy Patients with diagnosed malignancy Presence of mental retardation Patients with previous right hemicolectomy Patients with previous appendectomy Pregnant women

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Right Low Quadrant Pain<br>AIR and AAS scores will be calculated for the patients with right low quadrant pain in emergency service. | Diagnostic Test: Appendicitis Inflammatory Response<br>* A scoring system used to diagnose acute appendicitis. It consists of clinical findings and laboratory parameters<br>Diagnostic Test: Adult Appendicitis Score<br>* A scoring system used to diagnose acute appendicitis. It consists of clinical findings and laboratory parameters<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Exclude acute appendicitis | The ability of the scoring systems in detecting patients without acute appendicitis presenting with right lower quadrant pain to emergency service | 6 months | 
| Predicting the severity of acute appendicitis | The ability of scoring systems in predicting the rate of perforation in patients with acute appendicitis | 6 months |