Pre-operative Assessment of Acute Appendicitis Severity with Reference to a Structured Intra-Operative Grading System
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 2
Abstract
Background: The previously published Sunshine Appendicitis Grading System (SAGS) score was developed to standardize the intra-operative severity of acute appendicitis. The authors proposed a novel method of preoperative assessment using the SAGS score. The primary objective of this prospective study was to evaluate the ability of clinicians to assess the severity of acute appendicitis with reference to a standardized grading system. Methods: One hundred and thirty-one patients who underwent laparoscopy for suspected acute appendicitis at Sunshine Hospital were assessed. Based on clinical findings, patients were scored for suspected appendicitis severity at the time of clinical assessment by clinicians of the surgical unit. They were scored again following laparoscopy based on the SAGS score. Log-linear modelling of ordinal agreement data was used to find the model of best-fit. Results: The pre-operative and intra-operative SAGS score agreement index, weighted kappa (Kω) was 0.62 (95% confidence interval 0.51 to 0.74). The best-fit model of diagonal agreement plus linear-by-linear association showed no systematic bias (deviance χ2 7.56, P = 0.91). Conclusion: Pre-operative SAGS score assessment demonstrated a significant agreement with intra-operative findings and is a useful aid in decision-making under uncertainties in cases of suspected appendicitis.
Authors and Affiliations
Jacqueline Bakhit, Julian Choi, Lucy Lu, Carolyn Chew, Anh Vu, Steven Chan
Keywords
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- EP ID EP467303
- DOI 10.9790/0853-1802078488.
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