Appendicitis Inflammatory Response score

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Appendicitis Inflammatory Response score
PurposeDiagnosis of appendicitis

The Appendicitis Inflammatory Response (AIR) score is a diagnostic scoring system used to assist with the identification of appendicitis in children and adults.

History[]

The scoring system was developed in 2008.[1] The AIR score was developed to overcome some of the drawbacks of the Alvarado score, another diagnostic scoring system for identifying appendicitis.[2] The AIR score is one of the two scores (the other being the , AAS) recommended by the 2020 World Society of Emergency Surgery clinical practice guidelines for the diagnosis and treatment of acute appendicitis.[3]

Scoring and interpretation[]

The AIR score is calculated by tallying "points" ascribed to meeting its criteria, which are:[4]

  • Vomiting (no = 0, yes = 1)
  • Right iliac fossa (RIF) pain (no = 0, yes = 1)
  • Rebound tenderness (none = 0, light = 1, medium = 2, strong = 3)
  • Febrile (internal temperature ≥101.3ºF or 38.5ºC) (no = 0, yes = 1)
  • Polymorphonuclear leukocytes (<70% = 0, 70-84% = 1, ≥85% = 2)
  • White blood cell count (<10×109/L = 0, 10-14.9×109/L = 1, ≥15×109/L = 2)
  • Serum C-reactive protein (<10 mg/dL = 0, 10-49 mg/dL = 1, >50 mg/dL = 2)

Validation[]

A 2017 review found that the AIR score has a sensitivity of 92% and specificity of 63% if a score of 5 is used as a cut off for indicating a positive test, whereas the sensitivity is 20% and the specificity is 97% if a score of 8 is used.[5]

Limitations[]

While the AIR score has better predictive power than certain other diagnostic tools for appendicitis (e.g. the Alvarado score), it has only been validated in a small number of studies as of 2017.[5]

External links[]

References[]

  1. ^ Andersson, Manne; Andersson, Roland E. (August 2008). "The Appendicitis Inflammatory Response Score: A Tool for the Diagnosis of Acute Appendicitis that Outperforms the Alvarado Score". World Journal of Surgery. 32 (8): 1843–1849. doi:10.1007/s00268-008-9649-y.
  2. ^ de Castro, S. M. M.; Ünlü, Ç.; Steller, E. Ph.; van Wagensveld, B. A.; Vrouenraets, B. C. (July 2012). "Evaluation of the Appendicitis Inflammatory Response Score for Patients with Acute Appendicitis". World Journal of Surgery. 36 (7): 1540–1545. doi:10.1007/s00268-012-1521-4.
  3. ^ Di Saverio, Salomone; Podda, Mauro; De Simone, Belinda; Ceresoli, Marco; Augustin, Goran; Gori, Alice; Boermeester, Marja; Sartelli, Massimo; Coccolini, Federico; Tarasconi, Antonio; de'Angelis, Nicola; Weber, Dieter G.; Tolonen, Matti; Birindelli, Arianna; Biffl, Walter; Moore, Ernest E.; Kelly, Michael; Soreide, Kjetil; Kashuk, Jeffry; Ten Broek, Richard; Gomes, Carlos Augusto; Sugrue, Michael; Davies, Richard Justin; Damaskos, Dimitrios; Leppäniemi, Ari; Kirkpatrick, Andrew; Peitzman, Andrew B.; Fraga, Gustavo P.; Maier, Ronald V.; Coimbra, Raul; Chiarugi, Massimo; Sganga, Gabriele; Pisanu, Adolfo; de'Angelis, Gian Luigi; Tan, Edward; Van Goor, Harry; Pata, Francesco; Di Carlo, Isidoro; Chiara, Osvaldo; Litvin, Andrey; Campanile, Fabio C.; Sakakushev, Boris; Tomadze, Gia; Demetrashvili, Zaza; Latifi, Rifat; Abu-Zidan, Fakri; Romeo, Oreste; Segovia-Lohse, Helmut; Baiocchi, Gianluca; Costa, David; Rizoli, Sandro; Balogh, Zsolt J.; Bendinelli, Cino; Scalea, Thomas; Ivatury, Rao; Velmahos, George; Andersson, Roland; Kluger, Yoram; Ansaloni, Luca; Catena, Fausto (December 2020). "Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines". World Journal of Emergency Surgery. 15 (1): 27. doi:10.1186/s13017-020-00306-3.
  4. ^ "Appendicitis Inflammatory Response (AIR) Score". MDCalc. MDCalc. Retrieved 15 August 2020.
  5. ^ Jump up to: a b Kularatna, Malsha; Lauti, Melanie; Haran, Cheyaanthan; MacFater, Wiremu; Sheikh, Laila; Huang, Ying; McCall, John; MacCormick, Andrew D. (July 2017). "Clinical Prediction Rules for Appendicitis in Adults: Which Is Best?". World Journal of Surgery. 41 (7): 1769–1781. doi:10.1007/s00268-017-3926-6.
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