Scoring Systems in Acute Appendicitis - A Review

Abstract

Acute appendicitis is the most frequent cause leading to emergency laparotomy. In developing countries with resource limited settings, diagnosing appendicitis in its acute from is a challenge as clinical examination remains the cornerstone of diagnosis due to lack advanced radiological investigations and cost restraints. Presently, various modalities are in use to aid in indeterminate cases to decrease negative appendectomy rates. Scoring systems are amongst them. These systems take advantage of clinical history, physical signs and symptoms and laboratory findings. This article will recognize the widely used scoring systems and their accuracy and limitations in diagnosing acute appendicitis in adults. 32 studies have been included in this review till June 2020. A collective review of these studies regarding the application of scoring systems and their statistical significance in diagnosing acute appendicitis along with their limitations has been discussed and its conclusion noted in this review article. All the widely used scoring systems have some limitations in diagnosing acute appendicitis. Thus, the only way to decrease the morbidity and mortality associated with appendicitis is to make an ideal scoring system which is simple, reliable and cost effective.