DIAGNOTSTIC VALUE OF CLINICAL SYMPTOMS/SIGNS AND LEUKOCYTOSIS IN APPENDICITIS AT IMAM HOSEIN
UNIVERSITY HOSPITAL (1997-1999)

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BANA ZADEH H.; DAGHAGHALEH H.; VALAEI NASER; MOUMIVAND SH.

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Journal: Feyz Medical Sciences Journal Year:2000 | Volume:4 | Issue:14 Page(s): 83-90

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Title

DIAGNOTSTIC VALUE OF CLINICAL SYMPTOMS/SIGNS AND LEUKOCYTOSIS IN APPENDICITIS AT IMAM HOSEIN UNIVERSITY HOSPITAL (1997-1999)

Author(s)

BANA ZADEH H. | DAGHAGHALEH H. | VALAEI NASER | MOUMIVAND SH. | Issue Writer Certificate

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Abstract

History and Objectives: The inaccuracy of available diagnostic methods lead to an unacceptable high negative appendectomy and perforation rate. Our objective was to determine the value of clinical symptoms/signs and WBC differential count in the diagnosis of appendicitis in order to improve the accuracy of clinical diagnosis. Materials and Methods: In a clinical trial study, 914 consecutive patients with a clinical diagnosis of appendicitis, the value of abdominal pain and tenderness, pain shift, anorexia, vomiting, fever, tachycardia, leukocytosis and neutrophilly determined on the basis of P.P.V and N.P.V then analysed by Chi-square test. Results: From total of 914 patients evaluated, 61% were males and 39% females. The mean age was 24.7 ±12.4 years. Pathology revealed 700 positive appendicitis (cases) and 214 negative appendectomy (control). The most accurate diagnostic factors were neutrophilly leukocytosis and pain shift. Neutrophilly had a PPV=85 which means 15% diagnostic failure. It had N.P. V=38 which means 62% of patients who have not neutrophilly will have positive appendicitis (p < 0.0005), so this factor has a poor diagnostic value. Obviously other clinical and laboratory factors will have lower accuracy than neutrophilly, thus none will have any diagnostic value by themselves alone. For this reason, diagnostic value of more common symptoms was examined in combination for diagnosis of appendicitis. The most common and accurate factors were the combination of pain shift, anorexia, vomiting, leukocytosis and neutrophilly with P.P.V=92.4 and NP.V=36, which means only a 7.6% diagnostic failure. Conclusions: None of the clinical criteria and leukocytosis alone could have diagnostic power To predict appendicitis, however, the combination of several factors have more accurate predictive value and reduces the false appendectomy rate. The study revealed that with more attention to clinical symptoms, signs, leukocytosis and neutrophilly can improve clinical diagnosis and result in lower negative negative appendectomy and perforation rate significantly(p<0.0005).

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APA: Copy

BANA ZADEH, H., DAGHAGHALEH, H., VALAEI, NASER, & MOUMIVAND, SH.. (2000). DIAGNOTSTIC VALUE OF CLINICAL SYMPTOMS/SIGNS AND LEUKOCYTOSIS IN APPENDICITIS AT IMAM HOSEIN UNIVERSITY HOSPITAL (1997-1999). FEYZ, 4(14), 83-90. SID. https://sid.ir/paper/40483/en

Vancouver: Copy

BANA ZADEH H., DAGHAGHALEH H., VALAEI NASER, MOUMIVAND SH.. DIAGNOTSTIC VALUE OF CLINICAL SYMPTOMS/SIGNS AND LEUKOCYTOSIS IN APPENDICITIS AT IMAM HOSEIN UNIVERSITY HOSPITAL (1997-1999). FEYZ[Internet]. 2000;4(14):83-90. Available from: https://sid.ir/paper/40483/en

IEEE: Copy

H. BANA ZADEH, H. DAGHAGHALEH, NASER VALAEI, and SH. MOUMIVAND, “DIAGNOTSTIC VALUE OF CLINICAL SYMPTOMS/SIGNS AND LEUKOCYTOSIS IN APPENDICITIS AT IMAM HOSEIN UNIVERSITY HOSPITAL (1997-1999),” FEYZ, vol. 4, no. 14, pp. 83–90, 2000, [Online]. Available: https://sid.ir/paper/40483/en

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