Usefulness of scales to improve the diagnostic suspicion of acute appendicitis in the Emergency room of the Hospital General Puyo, 2021

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Anderson Robalino Díaz
Carolina Carrillo Medina
Mirian Sandoval Castañeda
Margarita Recalde Paredes
Mireya Alvarado Cajas
Katherine Valencia Chunllo
María Chiliquinga Cando
Luis Sánchez Vaca
María Ordoñez Saetama
Aida Ruíz Chicaiza
Flor Santiago Paguay
Petita Torres Bayas

Abstract

Context: Over the years, several scales have been developed to support the diagnosis and predict the severity of cases with a framework suggestive of acute appendicitis. In this investigation, these scales are compared.


Objective: To determine the degree of diagnostic certainty of the Alvarado and RIPASA scales as diagnostic support for Acute Appendicitis, at Hospital General Puyo, from 2021 to December 2021.


Methodology: Analytical, comparative, retrospective research, with diagnostic accuracy. Population and sample: Clinical histories of 105 adult patients admitted with a diagnosis of acute appendicitis during the study period. The SPSS v25.0 program was used, sensitivity (S), specificity (E), predictive values (PPV and NPV), likelihood ratios (LR+ and LR-), diagnostic OR (ORD), 95% CI and Receiver Operating Characteristic (ROC) curves. As reference questions, the criterion of the surgeon and the histopathological examination were taken. To compare both curves, the Hanley and McNeil statistics were used.


Results: Diagnostic accuracy: Alvarado: Sensitivity: 49.0% (35.9%-62.3%), Specificity: 50.0% (37.1%-62.9%); Positive Predictive Value: 48.1% (34.2%-62.2%); Negative Predictive Value: 50.9% (37.0-64.7%), Positive Likelihood Ratio: 0.9 (0.7-1.4), Negative Likelihood Ratio: 1.0 (0.7 -1.5); Odds diagnostic ratio: 0.9 (0.4-2.1), Area under the curve: 51.8% (40.6%-63.0%). RIPASA: Sensitivity: 76.5% (62.2%-86.7%), Specificity: 12.9% (5.8%-25.5%), Positive Predictive Value: 45.3% (34.7 %-56.4%), Negative Predictive Value: 36.8% (17.2%-61.4%), Positive Likelihood Ratio: 0.88 (0.73-1.06), Negative Likelihood Ratio: 1.82 (0.78-4.25), Odds diagnostic ratio: 0.48 (0.17-1.35), Area under the curve: 60.8% (49.7%-71.9%).


Conclusions: There were no significant differences between the RIPASA and Alvarado scales in relation to the diagnostic accuracy of acute appendicitis at the Hospital General de Puyo. In both cases, the performance was “discrete”; but, due to the characteristics of the show, this finding should not be generalized

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How to Cite
Robalino Díaz , A. ., Carrillo Medina , C., Sandoval Castañeda, M. ., Recalde Paredes , M. ., Alvarado Cajas , M., Valencia Chunllo , K., … Torres Bayas , P. . (2023). Usefulness of scales to improve the diagnostic suspicion of acute appendicitis in the Emergency room of the Hospital General Puyo, 2021. Mediciencias UTA, 7(2), 60–74. https://doi.org/10.31243/mdc.uta.v7i2.1988.2023
Section
Original research article

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