Acta clinica Croatica, Vol. 55. No. 4., 2016.
Original scientific paper
https://doi.org/10.20471/acc.2016.55.04.09
Sensitivity and specificity of Fenyö-Lindberg and Teicher scores in the diagnosis of acute appendicitis in women
Zrinko Madžar
; Clinical Department of Surgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Mario Kopljar
; Clinical Department of Surgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Tomislav Madžar
; School of Medicine, University of Zagreb, Zagreb, Croatia
Marko Mesić
; Clinical Department of Surgery, Zagreb Children's Hospital, Zagreb, Croatia
Dubravka Mužina Mišić
; Clinical Department of Surgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Slaven Čiček
; Clinical Department of Surgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Mario Zovak
; Clinical Department of Surgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; School of Dental Medicine, University of Zagreb, Zagreb, Croatia
Abstract
The aim of the study was to assess diagnostic accuracy (sensitivity and specificity) of Fenyö-Lindberg and Teicher scores for distinguishing patients that need immediate surgical treatment from the others, in a female population from an urban setting. The study prospectively included 130 female patients admitted to the emergency department with abdominal pain indicating acute appendicitis. The scores and parameters of validity were calculated and compared to definitive diagnosis. For Fenyö-Lindberg score of -17 or less, 84.5% sensitivity, 55.6% specificity, 87.9% positive predictive value (PPV) and 48.4% negative predictive value (NPV) were recorded. For cut-off value greater or equal to -2, there was 59.2% sensitivity, 77.8% specificity, 91% PPV and 33.3% NPV. The Receiver Operating Characteristic (ROC) curve analysis of Fenyö-Lindberg score showed that the best single cut-off value for discriminating acute appendicitis in the study population was -15. For Teicher score, values greater than -3 yielded 89.3% sensitivity and 22.2% specificity, 81.4% PPV and 35.3% NPV. In conclusion, Fenyö-Lindberg score could be used as an additional tool to exclude appendicitis and avoid unnecessary appendectomies. Teicher score may help in recognizing patients with appendicitis. None of the two scores can indicate or decline appendectomy in all cases. Scoring systems may be useful for pointing to important clinical signs and symptoms in specific subpopulations.
Keywords
Appendicitis – diagnosis; Women; Sensitivity; Specificity; ROC curve; Predictive value
Hrčak ID:
177950
URI
Publication date:
15.12.2016.
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