Comparison of current scoring methods in patients with acute appendicitis and the reliability of the scoring method to be new created

Introduction: Appendiceal disease is a frequent reason for emergency hospital admission, and appendectomy is one of the most common emergency procedures. There are different scoring systems in the literature for the diagnosis of acute appendicitis. The aim of this study is to develop a simple scoring system and to evaluate the performance of the newly created MBALA scoring system as compared to Alvarado, Ohmann and Eskelinen score. Material and Methods: Between 20.12.2017 - 20.12.2018, 306 patients who were admitted to the Emergency Department of Hitit University Erol Olçok Education and Research Hospital with abdominal pain and were diagnosed with acute appendicitis were prospectively evaluated using the Alvarado, Ohmann and Eskelinen scoring systems. The success of the scoring systems was evaluated by comparing the results of scoring systems with the results obtained by histopathological examinations. Investigation of MBALA score model strength with nausea or vomiting, fever, anorexia, leukocytosis, age, gender, capsule reactive protein, right lower quadrant guarding parameters Results: A total of 306 patients who underwent an appendectomy were enrolled in the study. There were 127 females and 179 males. The mean age was 35.79 ± 14.73 years (minimum 18 years and maximum 90 years). Sensitivity, specificity, positive and negative predictive values and overall accuracy for diagnosis with the Ohmann scoring system were 28,9%, 82,5%, 91,7%, 14,9% and 35,9%; with the Eskelinen score the values were 58. 3%, 57. 5%, 90,1%, 17. 2% and 58. 2%; with the Alvarado score the values were 72, 6%, 55, 5%, 91,5%, 23,2% and 70, 3%; with the MBALA score the values were 75,1%, 70,0%, 94,3%, 29,8% and 74,5%. The cut-off threshold of the MBALA score in distinguishing acute appendicitis from negative appendectomy was ≥14. MBALA scoring system was found to be the most reliable scoring system. Conclusion: The success of different scoring systems in the literature has been reported in different rates. In this study, the most accurate results were obtained from the MBALA scoring system and it was found to be more effective in distinguishing acute appendicitis from negative appendectomy. Also, age, right lower quadrant guarding, capsule reaktive protein and sex parameters are evaluated together in the first scoring model. Keywords: Appendicitis; Alvarado; MBALA score; Sensitivity.