PRIMENA ALVARADOVOG SKORA KOD SUMNJE NA AKUTNI APENDICITIS
Ključne reči:
alvarado, skor, apendicitis, ripasa
Sažetak
UVOD Apendicitis predstavlja zapaljenje apendiksa,sa pojavom simptoma u prvih 24 sata.Klinički se prezentuje bolom u abdomenu,najčešće u donjem desnom kvadrantu,povišenom temperaturom,gubitkom apetita,mučninom i povraćanjem.Zbog nespecifičnosti simptoma razvijeni su skoring sistemi da olakšaju postavljanje radne dijagnoze kod sumnje na akutni apendicitis,najčešće se koriste Alvaradov i AIR skor;CILJ RADA Prikaz upotrebe Alvaradovog skora na prehospitalnom nivou,kod sumnje na akutni apendicitis,kao i prikaz studija koje porede Alvaradov skor sa drugim skorovima.PRIKAZ BOLESNIKA Zavodu za urgentnu medicinu Beograd upućen je poziv za intervenciju,zbog bola u abdomenu. Pacijentkinja navodi da je bol počeo sinoć periumbiikalno,širio se u donji deo stomaka s desne strane,praćen mučninom i povišenom temperaturu 37.9C.Alvaradov skor bio je 6,pacijentkinja je transportovana u dežurnu zdravstvenu ustanovu gde je potvrđen akutnog apendicitisa.ZAKLJUČAK Dijagnostikovanje akutnog apendicitisa prehospitalno,bazira se na anamnezi i fizikalnom pregledu, zbog čega primena Alvaradovog skora može biti vrlo značajna,u cilju smanjenja rizika od komplikacija,morbiditeta i mortaliteta. KLJUČNE REČI alvarado, skor, apendicitis, ripasa
Reference
1. Lotfollahzadeh S, Lopez RA, Deppen JG. Appendicitis. 2024 Feb 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 29630245.
2. Snyder MJ, Guthrie M, Cagle S. Acute Appendicitis: Efficient Diagnosis and Management. Am Fam Physician. 2018 Jul 1;98(1):25-33. PMID: 30215950.
3. Téoule P, Laffolie J, Rolle U, Reissfelder C. Acute Appendicitis in Childhood and Adulthood. DtschArztebl Int. 2020 Nov 6;117(45):764-774. doi: 10.3238/arztebl.2020.0764. PMID: 33533331; PMCID: PMC7898047.
4. Awayshih MMA, Nofal MN, Yousef AJ. Evaluation of Alvarado score in diagnosing acute appendicitis. Pan Afr Med J. 2019 Sep 6;34:15. doi: 10.11604/pamj.2019.34.15.17803. PMID: 31762884; PMCID: PMC6859007.
5. Frountzas M, Stergios K, Kopsini D, Schizas D, Kontzoglou K, Toutouzas K. Alvarado or RIPASA score for diagnosis of acute appendicitis? A meta-analysis of randomized trials. Int J Surg. 2018 Aug;56:307-314. doi: 10.1016/j.ijsu.2018.07.003. Epub 2018 Jul 12. PMID: 30017607.
6. Andersson, R.E., Stark, J. Diagnostic value of the appendicitis inflammatory response (AIR) score. A systematic review and meta-analysis. World J EmergSurg 20, 12 (2025). https://doi.org/10.1186/s13017-025-00582-x
7. Chisthi MM, Surendran A, Narayanan JT. RIPASA and air scoring systems are superior to alvarado scoring in acute appendicitis: Diagnostic accuracy study. Ann Med Surg (Lond). 2020 Sep 24;59:138-142. doi: 10.1016/j.amsu.2020.09.029. PMID: 33024555; PMCID: PMC7527659.
8. Mehbub H, Baig AA, Khalid R, Mehmood MS, Ur Rehman O, Ghani U, Ahmad A. A Comparison of the Modified Alvarado Score and the Raja IsteriPengiranAnakSaleha Appendicitis (Ripasa) Score in a Southeast Asian Population With Histopathology as the Gold Standard. Cureus. 2023 Oct 9;15(10):e46715. doi: 10.7759/cureus.46715. PMID: 38021985; PMCID: PMC10630786.
9. Favara G, Maugeri A, Barchitta M, Ventura A, Basile G, Agodi A. Comparison of RIPASA and ALVARADO scores for risk assessment of acute appendicitis: A systematic review and meta-analysis. PLoS One. 2022 Sep 30;17(9):e0275427. doi: 10.1371/journal.pone.0275427. PMID: 36178953; PMCID: PMC9524677.
10. Zeb M, Khattak SK, Samad M, Shah SS, Shah SQA, Haseeb A. Comparison of Alvarado score, appendicitis inflammatory response score (AIR) and Raja IsteriPengiranAnakSaleha appendicitis (RIPASA) score in predicting acute appendicitis. Heliyon. 2023 Jan 16;9(1):e13013. doi: 10.1016/j.heliyon.2023.e13013. PMID: 36711320; PMCID: PMC9876948.
11. Inteti K, Shaik MR, Ganapa P, Gandi PS. A Comparison of the Alvarado Score and the Raja IsteriPengiranAnakSaleha Appendicitis (RIPASA) Score in the Diagnosis of Acute Appendicitis: A Prospective Cohort Study. Cureus. 2024 Aug 28;16(8):e68041. doi: 10.7759/cureus.68041. PMID: 39347188; PMCID: PMC11433655.
12. Tchoumi, Josianne1; Gruden, Enrico2; Elenga, Narcisse3; Kayemba-Kay’s, Simon4. Modified Alvarado and Samuel scores: Contribution to the diagnosis of acute appendicitis in the pediatric acute and emergency department. International Journal of Pediatrics and Adolescent Medicine 10(3):p 59-64, September 2023. | DOI: 10.4103/ijpam.ijpam_6_24
13. Pogorelić Z, Rak S, Mrklić I, Jurić I. Prospective validation of Alvarado score and Pediatric Appendicitis Score for the diagnosis of acute appendicitis in children. PediatrEmerg Care. 2015 Mar;31(3):164-8. doi: 10.1097/PEC.0000000000000375. PMID: 25706925.
14. Gebreselassie H, Zeleke H, Ashebir D. Diagnosis of Acute Appendicitis: A Cross-sectional Study on Alvarado's Score from a Low Income Country. Open Access Emerg Med. 2023 Jun 16;15:253-258. doi: 10.2147/OAEM.S410119. PMID: 37346382; PMCID: PMC10281270.
15. Sultana Z, Ali G, Nawaz H, Ali J, Ahmed A, Ali A, Tahir M, Jan Y. Accuracy of the Raja IsteriPengiranAnakSaleha Appendicitis (RIPASA) and Alvarado Score for Acute Appendicitis: A Comparative Study. Cureus. 2025 Oct 3;17(10):e93756. doi: 10.7759/cureus.93756. PMID: 41189820; PMCID: PMC12582032.
16. Mariage M, Sabbagh C, Grelpois G, Prevot F, Darmon I, Regimbeau JM. Surgeon's Definition of Complicated Appendicitis: A Prospective Video Survey Study. Euroasian J Hepatogastroenterol. 2019 Jan-Jun;9(1):1-4. doi: 10.5005/jp-journals-10018-1286. PMID: 31988858; PMCID: PMC6969325.
2. Snyder MJ, Guthrie M, Cagle S. Acute Appendicitis: Efficient Diagnosis and Management. Am Fam Physician. 2018 Jul 1;98(1):25-33. PMID: 30215950.
3. Téoule P, Laffolie J, Rolle U, Reissfelder C. Acute Appendicitis in Childhood and Adulthood. DtschArztebl Int. 2020 Nov 6;117(45):764-774. doi: 10.3238/arztebl.2020.0764. PMID: 33533331; PMCID: PMC7898047.
4. Awayshih MMA, Nofal MN, Yousef AJ. Evaluation of Alvarado score in diagnosing acute appendicitis. Pan Afr Med J. 2019 Sep 6;34:15. doi: 10.11604/pamj.2019.34.15.17803. PMID: 31762884; PMCID: PMC6859007.
5. Frountzas M, Stergios K, Kopsini D, Schizas D, Kontzoglou K, Toutouzas K. Alvarado or RIPASA score for diagnosis of acute appendicitis? A meta-analysis of randomized trials. Int J Surg. 2018 Aug;56:307-314. doi: 10.1016/j.ijsu.2018.07.003. Epub 2018 Jul 12. PMID: 30017607.
6. Andersson, R.E., Stark, J. Diagnostic value of the appendicitis inflammatory response (AIR) score. A systematic review and meta-analysis. World J EmergSurg 20, 12 (2025). https://doi.org/10.1186/s13017-025-00582-x
7. Chisthi MM, Surendran A, Narayanan JT. RIPASA and air scoring systems are superior to alvarado scoring in acute appendicitis: Diagnostic accuracy study. Ann Med Surg (Lond). 2020 Sep 24;59:138-142. doi: 10.1016/j.amsu.2020.09.029. PMID: 33024555; PMCID: PMC7527659.
8. Mehbub H, Baig AA, Khalid R, Mehmood MS, Ur Rehman O, Ghani U, Ahmad A. A Comparison of the Modified Alvarado Score and the Raja IsteriPengiranAnakSaleha Appendicitis (Ripasa) Score in a Southeast Asian Population With Histopathology as the Gold Standard. Cureus. 2023 Oct 9;15(10):e46715. doi: 10.7759/cureus.46715. PMID: 38021985; PMCID: PMC10630786.
9. Favara G, Maugeri A, Barchitta M, Ventura A, Basile G, Agodi A. Comparison of RIPASA and ALVARADO scores for risk assessment of acute appendicitis: A systematic review and meta-analysis. PLoS One. 2022 Sep 30;17(9):e0275427. doi: 10.1371/journal.pone.0275427. PMID: 36178953; PMCID: PMC9524677.
10. Zeb M, Khattak SK, Samad M, Shah SS, Shah SQA, Haseeb A. Comparison of Alvarado score, appendicitis inflammatory response score (AIR) and Raja IsteriPengiranAnakSaleha appendicitis (RIPASA) score in predicting acute appendicitis. Heliyon. 2023 Jan 16;9(1):e13013. doi: 10.1016/j.heliyon.2023.e13013. PMID: 36711320; PMCID: PMC9876948.
11. Inteti K, Shaik MR, Ganapa P, Gandi PS. A Comparison of the Alvarado Score and the Raja IsteriPengiranAnakSaleha Appendicitis (RIPASA) Score in the Diagnosis of Acute Appendicitis: A Prospective Cohort Study. Cureus. 2024 Aug 28;16(8):e68041. doi: 10.7759/cureus.68041. PMID: 39347188; PMCID: PMC11433655.
12. Tchoumi, Josianne1; Gruden, Enrico2; Elenga, Narcisse3; Kayemba-Kay’s, Simon4. Modified Alvarado and Samuel scores: Contribution to the diagnosis of acute appendicitis in the pediatric acute and emergency department. International Journal of Pediatrics and Adolescent Medicine 10(3):p 59-64, September 2023. | DOI: 10.4103/ijpam.ijpam_6_24
13. Pogorelić Z, Rak S, Mrklić I, Jurić I. Prospective validation of Alvarado score and Pediatric Appendicitis Score for the diagnosis of acute appendicitis in children. PediatrEmerg Care. 2015 Mar;31(3):164-8. doi: 10.1097/PEC.0000000000000375. PMID: 25706925.
14. Gebreselassie H, Zeleke H, Ashebir D. Diagnosis of Acute Appendicitis: A Cross-sectional Study on Alvarado's Score from a Low Income Country. Open Access Emerg Med. 2023 Jun 16;15:253-258. doi: 10.2147/OAEM.S410119. PMID: 37346382; PMCID: PMC10281270.
15. Sultana Z, Ali G, Nawaz H, Ali J, Ahmed A, Ali A, Tahir M, Jan Y. Accuracy of the Raja IsteriPengiranAnakSaleha Appendicitis (RIPASA) and Alvarado Score for Acute Appendicitis: A Comparative Study. Cureus. 2025 Oct 3;17(10):e93756. doi: 10.7759/cureus.93756. PMID: 41189820; PMCID: PMC12582032.
16. Mariage M, Sabbagh C, Grelpois G, Prevot F, Darmon I, Regimbeau JM. Surgeon's Definition of Complicated Appendicitis: A Prospective Video Survey Study. Euroasian J Hepatogastroenterol. 2019 Jan-Jun;9(1):1-4. doi: 10.5005/jp-journals-10018-1286. PMID: 31988858; PMCID: PMC6969325.
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