The role of adult appendicitis score in reducing the negative appendectomy rate

Mohamed Mahmoud Mansour El ghzzawy, Emergency Department, Faculty of Medicine, Mansoura University, 1Mansoura, EgyptFollow
Magdy Basheer, General surgery Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Mohamed Balata, General surgery Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Amir A. Fikry, General surgery Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Corresponding Author

Mohamed Mahmoud Mansour El ghzzawy

Subject Area

General Surgery

Article Type

Original Study

Abstract

Aim: Approximately 15 – 30% of all acute appendectomies are performed based only on clinical suspicion. A negative appendectomy has a 10–12% morbidity rate, which could be detrimental to patients. The current study aimed to evaluate the effectiveness of adult appendicitis score (AAS) in accurate identification of cases with acute appendicitis.

Patients and Methods: This prospective observational study was conducted on 150 patients who presented with manifestations of acute appendicitis admitted to Mansoura Emergency Hospital. The AAS was calculated, the decision on appendectomy was solely based on the surgeon’s clinical judgment after taking into consideration all the findings of clinical, laboratory, and radiological investigation. All the excised specimens were sent to the pathology laboratory to confirm the diagnosis.

Results: The AAS demonstrated excellent discriminatory performance at the optimal cut-off (AAS ≥ 11). The ROC analysis showed a high area under the curve (AUC = 0.893), indicating strong overall diagnostic accuracy, and the result was statistically significant (p < 0.001). At this threshold, the score achieved high sensitivity (93.9) and specificity (85.7%). Several variables demonstrated statistically significant associations with appendectomy status in the univariate analysis. In the multivariate analysis, AAS was the only significant predictor for appendectomy (p<0.001).

Conclusion: The present prospective study demonstrated that the AAS is a precise and dependable method for diagnosing acute appendicitis in adult patients presenting with right lower quadrant abdominal pain. The score showed excellent discriminative performance, with a high area under the ROC curve and strong sensitivity and specificity at the identified optimal cutoff value.

Recommended Citation

El ghzzawy, Mohamed Mahmoud Mansour; Basheer, Magdy; Balata, Mohamed; and Fikry, Amir A. (2026) "The role of adult appendicitis score in reducing the negative appendectomy rate," Mansoura Medical Journal: Vol. 56 : Iss. 1 , Article 7.
Available at: https://doi.org/10.58775/2735-3990.1573