Muhammad Laiquz Zaman Khan1, Manzar2 S.
Evaluation of Ramirez & Deus` clinical diagnostic scoring for acute appendicitis at Civil Hospital, Karachi
Pak J Surg Apr - Jun 2003;19(1):3-8.
Department of Surgery, Dow Medical College and Civil Hospital, Karachi

This prospective and descriptive study was carried out at Civil Hospital, Karachi to evaluate the efficacy and applicability of Ramirez and Deus` clinical diagnostic scoring in acute appendicitis. One hundred and fifty consecutive patients with suspected acute appendicitis were included in the study. They were given specific scores according to the given variables i.e. sex, initial pain, diarrhoea, rebound tenderness, guarding, total leucocyte count and differential leucocyte count. Patients with a score of <-15 were discharged, whereas those with score between –15 to 9 were kept under observation and those with score 10 underwent surgery. One hundred and eight patients underwent removal of their appendix with a negative appendicectomy rate of 16.6% (9.5% in males and 26.6% in females). The perforation rate was 10%. The sensitivity, specificity, positive predictive value and diagnostic accuracy were 77%, 92%, 93% and 83% respectively. The complication rate was 16.5%. It is concluded that this scoring system is simple and ideal for supporting the diagnosis of acute appendicitis, especially for the junior doctors.

Category: Surgery
Keywords: Appendicitis. Appendix. Scoring System.

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