Validation of the diagnostic score for acute lower abdominal pain in women of reproductive age.

Kijja Jearwattanakanok,Waratsuda Smuthtai,Sirikan Yamada,Jayanton Patumanond,Watcharin Suntornlimsiri

doi:10.1155/2014/320926

Kijja Jearwattanakanok, Waratsuda Smuthtai + Show 3 more

Open Access

https://doi.org/10.1155/2014/320926

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Abstract

Background. The differential diagnoses of acute appendicitis obstetrics, and gynecological conditions (OB-GYNc) or nonspecific abdominal pain in young adult females with lower abdominal pain are clinically challenging. The present study aimed to validate the recently developed clinical score for the diagnosis of acute lower abdominal pain in female of reproductive age. Method. Medical records of reproductive age women (15–50 years) who were admitted for acute lower abdominal pain were collected. Validation data were obtained from patients admitted during a different period from the development data. Result. There were 302 patients in the validation cohort. For appendicitis, the score had a sensitivity of 91.9%, a specificity of 79.0%, and a positive likelihood ratio of 4.39. The sensitivity, specificity, and positive likelihood ratio in diagnosis of OB-GYNc were 73.0%, 91.6%, and 8.73, respectively. The areas under the receiver operating curves (ROC), the positive likelihood ratios, for appendicitis and OB-GYNc in the validation data were not significantly different from the development data, implying similar performances. Conclusion. The clinical score developed for the diagnosis of acute lower abdominal pain in female of reproductive age may be applied to guide differential diagnoses in these patients.

Highlights

The differential diagnoses of acute appendicitis obstetrics, and gynecological conditions (OB-GYNc) or nonspecific abdominal pain in young adult females with lower abdominal pain are clinically challenging
Abdominal pain is one of the most common chief complaints of emergency department patients. It was the main symptom of 12.1% to 20.4% of noninjury visits to emergency departments of USA, and 16.8% to 17.8% of them were in severe conditions [1]
It is difficult to diagnose the causes of abdominal pain in some patients

Summary

Introduction

The differential diagnoses of acute appendicitis obstetrics, and gynecological conditions (OB-GYNc) or nonspecific abdominal pain in young adult females with lower abdominal pain are clinically challenging. The present study aimed to validate the recently developed clinical score for the diagnosis of acute lower abdominal pain in female of reproductive age. The areas under the receiver operating curves (ROC), the positive likelihood ratios, for appendicitis and OB-GYNc in the validation data were not significantly different from the development data, implying similar performances. The clinical score developed for the diagnosis of acute lower abdominal pain in female of reproductive age may be applied to guide differential diagnoses in these patients. Diagnosis of acute lower abdominal pain in young adult females was difficult due to overlapping symptoms of obstetrics and gynecological conditions with those of acute appendicitis. Negative appendectomies often occurred mostly from missed diagnoses of obstetrics and gynecological conditions [3]

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Conclusion