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Integral Diagnosis of Acute Appendicitis

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Author(s): R.R. Kasimov | А.А. Mukhin

Journal: Sovremennye Tehnologii v Medicine
ISSN 2076-4243

Issue: 4;
Start page: 112;
Date: 2012;
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Keywords: Acute appendicitis | С-reactive protein | Integral diagnostics of acute appendicitis | Acute appendicitis diagnostic score | Unreasonable appendectomy

ABSTRACT
Dissatisfaction with the results of acute appendicitis diagnostics has given rise to the development of an integral diagnostic technique based on the use of diagnostic scores. The objects of the research were conscripts admitted to a military hospital with suspected acute appendicitis. In addition to routine diagnosis, there was developed Acute Appendicitis Initial Diagnosis Score and Acute Appendicitis Diagnosis Score, in which there was used a new criterion — C-reactive protein concentration in venous blood. The characteristics of the test were the following: sensitivity — 58.8%, specificity — 92.3%, overall accuracy — 73.3%, false-negative response – 41.2%, false-positive — 7.7%, positive predicted value — 90.9%. On integrating the data matrixes of these retrospective and prospective studies, there was developed the final score of acute appendicitis diagnosis with the following characteristics: sensitivity — 94.1%, specificity — 100%, overall accuracy — 96.7%, false-negative response — 5.9%, false-positive response — 0%, positive predicted value — 100%. The test was approved on 30 patients. There were no cases of resection of normal or catarrhal vermix. In 17 cases destructive appendicitis was diagnosed. 13 patients were discharged with the diagnosis of appendicular colic. The proposed complex integral approach enables to improve the efficiency of noninvasive diagnostics of acute appendicitis.
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