Scopus
🔓 Açık Erişim
Nationwide prospective audit for the evaluation of appendicitis risk prediction models in adults: Right iliac fossa treatment (RIFT) - Turkey
BJS Open · Ekim 2024
Makale Bilgileri
DergiBJS Open
Yayın TarihiEkim 2024
Cilt / Sayfa8
Scopus ID2-s2.0-85205957560
Erişim🔓 Açık Erişim
Özet
Background: Appendicitis is the most prevalent surgical emergency. The negative appendicectomy rate and diagnostic uncertainty are important concerns. This study aimed to assess the effectiveness of current appendicitis risk prediction models in patients with acute right iliac fossa pain. Methods: A nationwide prospective observational study was conducted, including all consecutive adult patients who presented with right iliac fossa pain. Diagnostic, clinical and negative appendicectomy rate data were recorded. The Alvarado score, Appendicitis Inflammatory Response (AIR), Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and Adult Appendicitis Score systems were calculated with collected data to classify patients into risk categories. Diagnostic value and categorization performance were evaluated, with use of risk category-based metrics including 'true positive rate' (percentage of appendicitis patients in the highest risk category), 'failure rate' (percentage of patients with appendicitis in the lowest risk category) and 'categorization resolution' (true positive rate/failure rate). Results: A total of 3358 patients from 84 centres were included. Female patients were less likely to undergo surgery than men (71.5% versus 82.5% respectively; relative risk 0.866, 95% c.i. 0.834 to 0.901, P < 0.001); with a three-fold higher negative appendicectomy rate (11.3% versus 4.1% respectively; relative risk 2.744, 95% c.i. 2.047 to 3.677, P < 0.001). Ultrasonography was utilized in 56.8% and computed tomography in 75.2% of all patients. The Adult Appendicitis Score had the best diagnostic performance for the whole population; however, only RIPASA was significant in men. All scoring systems were successful in females patients, but Adult Appendicitis Score had the highest area under the receiver operating characteristic curve value. The RIPASA and the Adult Appendicitis Score had the best categorization resolution values, complemented by their exceedingly low failure rates in both male and female patients. Alvarado and AIR had extremely high failure rates in men. Conclusion: The negative appendicectomy rate was low overall, but women had an almost three-fold higher negative appendicectomy rate despite lower likelihood to undergo surgery. The overuse of imaging tests, best exemplified by the 75.2% frequency of patients undergoing computed tomography, may lead to increased costs. Risk-scoring systems such as RIPASA and Adult Appendicitis Score appear to be superior to Alvarado and AIR.
Yazarlar (100)
1
Ali Yalcinkaya
ORCID: 0000-0002-5427-8118
2
Ahmet Yalcinkaya
ORCID: 0000-0002-1172-3330
3
Bengi Balci
4
Can Keskin
5
Ibrahim Erkan
6
Alp Yildiz
7
Erdinc Kamer
8
Sezai Leventoglu
9
Mehmet Caglikulekci
10
Elbrus Zarbaliyev
11
Murat Sevmis
12
Yigit Ulgen
13
Yuksel Altinel
14
Serhat Meric
15
Ahmet Akbas
16
Nadir Adnan Hacim
17
Talar Vartanoglu Aktokmanyan
18
Yunus Emre Aktimur
19
Fikret Calikoglu
20
Hasim Furkan Gullu
21
Ahmet Guray Durma
22
Sami Acar
23
Erman Ciftci
24
Emre Balik
25
Cemil Burak Kulle
26
Ibrahim Halil Ozata
27
Tutku Tufekci
28
Cihad Tatar
29
Mert Mahsuni Sevinc
30
Husnu Sevik
31
Candeniz Ertürk
32
Irem Nur Kiraz
33
Volkan Ozben
34
Erman Aytac
35
Zumrud Aliyeva
36
Arda Ulas Mutlu
37
Mert Tanal
38
Mustafa Fevzi Celayir
39
Emre Bozkurt
40
Sitki Gurkan Yetkin
41
Emin Ergin
42
Wafi Attaallah
43
Tevfik Kivilcim Uprak
44
Ahmet Omak
45
Oguzhan Simsek
46
Mehmet Abdussamet Bozkurt
47
Yasin Kara
48
Emre Bozdag
49
Hakan Yirgin
50
Adem Ozcan
51
Nuri Okkabaz
52
Yasar Ozdenkaya
53
Mustafa Celalettin Haksal
54
Caglar Kazim Pekuz
55
Sila Duru
56
Emre Sivrikoz
57
Yavuz Ozdemir
58
Necati Tan
59
Feza Yarbug Karayali
60
Abdulla Taghiyeva
61
Ismail Tirnova
62
Ilknur Erenler Bayraktar
63
Onur Bayraktar
64
Emine Zulal Emsal
65
Munevver Irem Dalkilic
66
Metin Yesiltas
67
Hasan Tok
68
Dursun Ozgur Karakas
69
Ali Pusane
70
Ali Ilbey Demirer
71
Hasan Berk Sahin
72
Ali Fuat Kaan Gok
73
Halil Alper Bozkurt
74
Mehmet Iskender Yildirim
75
Gorkem Uzunyolcu
76
Hakan Teoman Yanar
77
Sefa Ergun
78
Fadime Kutluk
79
Server Sezgin Uludag
80
Abdullah Kagan Zengin
81
Mehmet Faik Ozcelik
82
Ahmet Necati Sanli
83
Yunus Emre Altuntas
84
Ecem Memisoglu
85
Ramazan Sari
86
Osman Akdogan
87
Hasan Fehmi Kucuk
88
Omer Faruk Ozkan
89
Hanife Seyda Ulgur
90
Emre Furkan Kirkan
91
Sema Yuksekdag
92
Ahmet Rencuzogullari
93
Melik Kagan Aktas
94
Murat Aba
95
Ahmet Onur Demirel
96
Ismail Cem Eray
97
Burak Aydogan
98
Suleyman Cetinkunar
99
Kemal Yener
100
Alper Sozutek
Kurumlar
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Bülent Ecevit University
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Çukurova Üniversitesi
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Didim State Hospital
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Dokuz Eylül Üniversitesi
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Elazig Fethi Sekin City Hospital
Elazig Turkey
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Florence Nightingale Hospital
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Gazi University, Faculty of Medicine
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Hacettepe Üniversitesi
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İstanbul Medipol Üniversitesi
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İstanbul Tıp Fakültesi
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İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine
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İstanbul Yeni Yüzyıl University Gaziosmanpaşa Hospital
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Izmir Bakircay University
Izmir Turkey
İzmir Kâtip Çelebi Üniversitesi
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Kanuni Sultan Suleyman Training and Research Hospital
Istanbul Turkey
Kartal Dr. Lütfi Kırdar City Hospital
Istanbul Türkiye
Kestel State Hospital
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Koç Üniversitesi
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Konya Turkey
Liv Hospital
Ankara Turkey
Marmara Üniversitesi Tip Fakültesi
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Medicana Bursa Hospital
Bursa Turkey
Mustafa Kemal Üniversitesi
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Necip Fazil City Hospital
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Private Pendik Regional Hospital
Istanbul Turkey
Prof. Dr. Cemil Tascioglu City Hospital
Istanbul Turkey
Selçuk Üniversitesi
Selçuklu Turkey
Sincan State Hospital
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T. C. Sağlik Bakanliği, Tire Devlet Hastanesi
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T. C. Sağlık Bakanlığı, Taksim Eğitim ve Araştirma Hastanesi
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T. C. Sağlık Bakanlığı, Urla Devlet Hastanesi
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Tibbi Akademik
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Umraniye Training and Research Hospital
Istanbul Turkey
University of Health Sciences
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Uppsala Universitet
Uppsala Sweden
Yenimahalle Training and Research Hospital
Ankara Turkey
Zeynep Kamil Women and Children's Diseases Training and Research Hospital
Istanbul Türkiye