Original Article

Evaluation of Four Different Scoring Systems in the Management of Acute Appendicitis; a Prospective Clinical Study


  • Ekrem Ferlengez
  • Ayşe Gül Ferlengez
  • Hüseyin Akbulut
  • Hüseyin Kadıoğlu

Received Date: 25.08.2012 Accepted Date: 28.08.2012 Med Bull Haseki 2013;51(1):15-17


In the literature, there are many clinical studies on different scoring systems in the management of acute appendicitis as well as on the sensitivity and specificity of these scoring systems. In this clinical study, we compared true and false positive rates in four different scoring systems.


Patients who were admitted to the emergency department of Bezmialem Vakıf University Medical Faculty Hospital between January 2012 and April 2012 and underwent surgery for acute appendicitis were prospectively evaluated using the Alvarado, the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA), Tzanakis and, the Lintula scoring systems. Surgeons decided for surgery based on clinical evaluation without knowing the results of the scoring systems. The success of scoring systems was evaluated by comparing the results of scoring systems with the results obtained by histopathological examinations.


Between January 2012 and April 2012, 45 patients (27 males, 18 females; mean age: 30.7±12 years) were operated for acute appendicitis in the general surgery department at the Bezmialem Vakif University Medical School. Alvarado, RIPASA, Lintula and Tzanakis scores and their false positive and false negative rates were evaluated. It was observed that false negative rates were very high, however, the Tzanakis scoring system was found to be the most reliable scoring tool among these systems.


The most accurate results were obtained from Tzanakis scoring system which incorporates ultrasound examination and particular elements of clinical evaluations and laboratory investigations. Our study has shown that scoring systems had no advantage over clinical assessment.

Keywords: Appendicitis, scoring systems

Full Text (Turkish)