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KMID : 0371319960510050714
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Journal of the Korean Surgical Society
1996 Volume.51 No. 5 p.714 ~ p.721
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The Effects of Combination of Ultrasonography and a Scoring System in the Diagnosis of Appendicitis
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Abstract
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This study was designed to standardize the diagnosing process of appendicitis and to improve diagnostic efficiency by combining the ultrasonography (USG) and a scoring system. Two cohort studies were performed. Retrospectively, 452 consecutive
patients
who and undergone appendectomy were reviewed in order to build a scoring system. The negative laparotomy rate (NLR) in this study sample was 17.9%. USG was performed on 29.6% of patients. Seventy one patients (15.7%) were delayed for their
surgery
because of their undefined diagnosis. The diagnostic weight (DW) of each diagnostic variables were calculated by the Bayesian method using data of study sample. The diagnostic score (DS) was defined the sum of DW of each patients. In diagnosis
scoring
system, each patients were assigned into group of surgery, discharge or undefined diagnosis according to their DS. We regarded only the patients of undefined diagnosis to deserve to be studied with USG, which may help to decide them to be
undergone
surgery or not. A second cohort, 81 consecutive patients were evaluated by diagnosis system prospectively. They revels 14.0% of NLR. Only 19.4% of patients were requested for USG. Eight per cent of patients were delayed for surgery because of
undefined
diagnosis. Our USG assisted diagnosis scoring system reveals improved diagnostic accuracy and cost effectiveness.
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KEYWORD
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