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Table 3 Scoring systems used for identifying complicated appendicitis

From: Periappendiceal fat-stranding models for discriminating between complicated and uncomplicated acute appendicitis: a diagnostic and validation study

Models Variables required Points scored Cutoff/total points Sensitivity (95% CI) Specificity (95% CI) ROC c statistics (95% CI)
1. Bröker et al. [32] CRP ≥ 3.0 (1) 2/2 64.1% (52.3–75.8%) 83.1% (79.1–87.1%) 0.778 (0.719–0.837)
  Duration of symptoms ≥ 2 days (1)     
2. Imaoka et al. [28] Temp ≥ 37.4 °C (1) 1/3 84.9% (77.4–94.5%) 68.6% (63.7–73.6%) 0.800 (0.745–0.854)
  CRP ≥ 4.7 (1)     
  Periappendiceal fluid Yes (1)     
3. Khan et al. [16] Age 40–59 years (1) 2/4 73.4% (62.6–84.3%) 58.8% (53.6–61.1%) 0.694 (0.630–0.759)
   ≥ 60 years (2)     
  Duration of symptoms ≥ 2 days (1)     
  Appendicolith Yes (1)     
4. TH Kim et al. [33] Appendiceal diameter > 10 mm (1) 3/4 56.3% (44.1–68.4%) 86.1% (82.4–89.8%) 0.777 (0.718–0.835)
  Ascites Yes (1)     
  Fat stranding Yes (1)     
  CRP > 5.0 mg/dL (1)     
5. Kang et al. [34] Temp ≥ 37.9 °C (1) 4/8 60.9% (49.0–72.9%) 85.2% (81.4–89.0%) 0.772 (0.706–0.839)
  Abdominal pain score 4–6 (1), ≥ 7 (2)     
  WBC count > 13,660/μL (1)     
  NLR ≥ 10.9 (1)     
  CRP ≥ 6.6 (3)     
6. Atema et al. [31] Age ≥ 45 years (2) 7/22 76.6% (66.2–86.9%) 74.8% (70.2–79.5%) 0.826 (0.774–0.878)
  Temp ≤ 37.0 °C (0)     
   37.1–37.9 °C (2)     
   ≥ 38.0 °C (4)     
  Duration of symptoms ≥ 48 h (2)     
  WBC count > 13,000/μL (2)     
  CRP (mg/dL) ≤ 5.0 (0)     
   5.0–10.0 (1)     
   > 10.0 (2)     
  Extraluminal free air Present (5)     
  Periappendiceal fluid Present (2)     
  Appendicolith Present (2)     
7. Avanesov et al. [36] Age ≥ 52 years (1) 2/10 81.3% (71.7–90.8%) 69.2% (64.3–74.2%) 0.806 (0.749–0.862)
  Temp ≥ 37.5 °C (1)     
  Duration of symptoms ≥ 48 h (1)     
  Appendix diameter ≥ 14 mm (1)     
  Periappendiceal fluid Present (2)     
  Extraluminal air present Present (1)     
  Abscess Present (3)     
8. HY Kim et al. [37] Segmented neutrophils ≥ 81% (1) 3/6 64.1% (52.3–75.8%) 87.6% (84.1–91.0%) 0.838 (0.788–0.889)
  Contrast-enhancement of the appendiceal wall Defect (1)     
  Abscess Present (1)     
  Fat stranding Moderate or severe (1)     
  Appendiceal diameter ≥ 10 mm (1)     
  Extraluminal air Present (1)     
9. Model 1 (our model) CRP (mg/dL) 3.0–5.9 (2) 6/10 82.8% (73.6–92.1%) 82.8% (78.5–86.6%) 0.878 (0.829–0.928)
   ≥ 6.0 mg/dL (3)     
  Fat stranding Grade 1 (3)     
   Grade 2 (4)     
   Grade 3 (5)     
  Appendicolith Present (1)     
  Ascites Present (1)     
10. Model 2 (our model) CRP (mg/dL) 3.0–5.9 (2) 6/10 81.3% (71.7–90.8%) 82.3% (78.2–86.3%) 0.879 (0.830–0.927)
   ≥ 6.0 mg/dL (3)     
  Fat stranding Grade 1 (3)     
   Grade 2 (4)     
   Grade 3 (5)     
  NLR > 10 (1)     
  Ascites Present (1)     
  1. CRP C-reactive protein, CRP C-reactive protein, CT computed tomography, NLR neutrophil to lymphocyte ratio, WBC white blood cell
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World Journal of Emergency Surgery

ISSN: 1749-7922