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Table 2 Comparison of the most popular and validated clinical scores for the diagnosis of AA

From: WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis

 

Alvarado scorea

AIR scoreb

PAS scorec

RIPASA scored

AAS scoree

Vomiting

 

1

   

Nausea or vomiting

1

 

1

1

 

Anorexia

1

 

1

1

 

Pain in RIFf

2

1

 

0.5

2

Migration of pain to the RIFf

1

 

1

0.5

2

Rovsing’s sign

   

2

 

RIFg tenderness

  

2

1

 

 Women >50 years or men (any age)

    

3

 Women <50 years

    

1

Rebound tenderness or muscular defense/guarding

1

  

1 + 2

 

 Light

 

1

  

2

 Medium

 

2

  

4

 Strong

 

3

  

4

Body temperature

     

  > 37.5 °C

1

 

1

  

  > 38.5 °C

 

1

   

  > 37– <39 °C

   

1

 

WBC (white blood cell) count

   

  > 10.0 × 109/l

2

 

1

1

 

 10.0–14.9 × 109/l

 

1

   

  ≥ 15.0 × 109/l

 

2

   

  ≥ .2 and <10.9 × 109/l

    

1

  ≥ 10.9 and <14.0 × 109/l

    

2

  ≥ 14.0 × 109/l

    

3

Leukocytosis shift

1

    

Polymorphonuclear leukocytes

   

 70–84 %

 

1

   

  ≥ 75 %

  

1

  

  ≥ 85 %

 

2

   

  ≥ 62 % and < 75 %

    

2

  ≥ 75 % and < 83 %

    

3

  ≥ 83 %

    

4

CRP (C-reactive protein) concentration

   

 10–49 mg/l

 

1

   

  ≥ 50 mg/l

 

2

   

Symptoms <24 h and CRP (C-reactive protein) concentration

   

  ≥ 4 and <11 mg/l

    

2

  ≥ 11 and <25 mg/l

    

3

  ≥ 25 and <83 mg/l

    

5

  ≥ 83 mg/l

    

1

Symptoms >24 h and CRP (C-reactive protein) concentration

   

  ≥ 12 and <53 mg/l

    

2

  ≥ 53 and <152 mg/l

    

2

  ≥ 152 mg/l

    

1

Coughing/hopping/percussion pain

  

2

  

Gender

     

 Male

   

1

 

 Female

   

0.5

 

Age

     

  < 40 years

   

1

 

  ≥ 40 years

   

0.5

 

Duration of symptoms

     

  < 48 h

   

1

 

  > 48 h

   

0.5

 

Negative urinalysis

   

1

 

Total score

10

12

10

16.5

23

  1. aAlvarado score: sum 0–4 = not likely appendicitis, sum 5–6 = equivocal, sum 7–8 = probably appendicitis, sum 9–10 = highly likely appendicitis
  2. bAcute appendicitis response score (AIR): sum 0–4 = low probability, sum 5–8 = indeterminate group, sum 9–12 = high probability [161]
  3. cPediatric appendicitis score (PAS): ≥6 = appendicitis, ≤5 = observe
  4. dRaja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score
  5. eAdult Appendicitis Score (AAS): low risk (0–10 points), intermediate risk (11–15 points), high risk (≥16 points)
  6. f right iliac fossa