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.