Validation of the Appendicitis Inflammatory Response (AIR) Score During Pregnancy: A Nested Case-Control Study

Validation of the Appendicitis Inflammatory Response (AIR) Score During Pregnancy: A Nested Case-Control Study

Authors: Elin Moltubak, Kalle Landerholm, Marie Blomberg, Roland E Andersson

Published in: Academic Emergency Medicine, 2024 April 11

Conclusions:

The AIR score shows promise as an effective tool for risk stratification of appendicitis in pregnant women, potentially reducing the incidence of unnecessary surgeries. However, further validation in a pregnant population is recommended to confirm these findings.

Methods:

  • Utilized data from national Swedish health registries, focusing on women who underwent appendectomy during pregnancy and those admitted for acute abdominal pain but diagnosed with non-specific abdominal pain (NSAP).
  • The study involved 154 pregnant women with suspected appendicitis who underwent surgery and 232 matched controls with NSAP.
  • Evaluated the effectiveness of the AIR score and various imaging techniques in diagnosing appendicitis.

Results:

  • Among the surgical patients, diagnoses were divided into uncomplicated appendicitis (49.4%), complicated appendicitis (26.6%), and negative appendectomy (24%).
  • Diagnostic imaging was performed in 41% of cases, primarily using ultrasonography, with sensitivity and specificity of 44.9% and 42.2%, respectively.
  • The AIR score demonstrated high accuracy with an area under the curve (AUC) of 0.88 for all appendicitis cases and 0.90 for complicated cases.
  • At an AIR score of ≥4, the sensitivity for detecting complicated appendicitis was 100%, and specificity for all appendicitis cases was 97% at a score of ≥9.
Moltubak, E., Landerholm, K., Blomberg, M. and Andersson, R.E., 2024. Validation of the Appendicitis Inflammatory Response (AIR) score during pregnancy: A nested case–control study. Academic Emergency Medicine.
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