Diagnostic accuracy of Tzanakis score in acute appendicitis in Mulago Hospital

Abstract

Background: Diagnosis of Acute Appendicitis is not always a straight forward process; sometimes its presentation is so atypical even for the most experienced surgeon leading to false positives of (15% to 37.6%) and false negatives of (10% to 30%) which remain common in the surgical management of acute appendicitis despite attempts of improving diagnostic accuracy even in developed countries. Objective: To compare the accuracy of the Tzanakis Scoring system with the histopathology report of the removed appendix. Design: Observational Cross sectional diagnostic Accuracy study Setting: Mulago National Referral Hospital in Kampala -Uganda Methods: This was an observational cross sectional diagnostic accuracy study assessing the Tzanakis scoring system with the final histopathological report of patients admitted with suspected acute appendicitis at Mulago hospital between July 1st 2014 and April 30th 2015. Results: Tzanakis score of ≥13 was 100% sensitive and 63.6 specific to acute appendicitis with positive predictive value of 97.4% and negative predictive value of 100%. The overall diagnostic accuracy of Tzanakis score for acute appendicitis was 97.5%. Conclusion: Tzanakis scoring system can be used as an effective modality to establish an accurate diagnosis of acute appendicitis