Comparative Study on the Diagnostic Validity of the Alvarado Score, Appendicitis Inflammatory Response (AIR), and Adult Appendicitis Score (AAS) in Acute Appendicitis at East Lancashire Hospitals NHS Trust (ELHT)

NCT07804238 | Completed

• 1 other identifier: DEV123
• Study Type: observational
• Target: 300
• Locations: 1 country
• Sites: 1

Brief Summary

This retrospective observational study aims to compare the diagnostic accuracy of Alvarado Score, Appendicitis Inflammatory Response (AIR) Score, and Adult Appendicitis Score (AAS) in predicting histologically confirmed acute appendicitis in adult patients presenting to East Lancashire Hospitals NHS Trust (ELHT). The study will include all emergency patients aged 16 years and above, of any gender, admitted between June 2023 and June 2024 with clinical suspicion of acute appendicitis who subsequently underwent appendicectomy via laparoscopic or open approaches. For each patient, the Alvarado, AIR, and AAS scores will be calculated retrospectively using information from presenting symptoms, physical examination findings, and laboratory investigations recorded at the time of admission. These calculated scores will be compared against the final histopathology results, which serve as the gold standard for diagnosis. Diagnostic performance will be assessed using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Sensitivity reflects the proportion of patients with appendicitis correctly identified by the score, while specificity measures the ability to correctly exclude those without the condition. PPV indicates the likelihood that a positive score truly represents acute appendicitis, whereas NPV represents the likelihood that a negative score accurately rules it out. Accurate and timely pre-operative diagnosis of acute appendicitis is essential to minimise the incidence of negative appendicectomies while avoiding unnecessary diagnostic investigations. This study also aims to determine the most effective scoring system for risk stratification in the local adult population, considering the demographic diversity, and to provide recommendations for the standardisation of appendicitis risk assessment tools in emergency surgical practice within the trust.

Conditions

Acute Appendicitis

Keywords

Acute appendicitis; Alvarado score; Appendicitis Inflammatory Response (AIR) score; Adult Appendicitis Score (AAS); Diagnostic accuracy

Outcome Measures

Primary Outcomes (1)

• Diagnostic Accuracy

  Which scoring system - Alvarado Score, Appendicitis Inflammatory Response (AIR) Score or Adult Appendicitis Score (AAS) has the highest diagnostic accuracy for predicting histologically confirmed appendicitis among patients undergoing emergency appendicectomy? \[Diagnostic accuracy will be assessed by comparing their sensitivity, specificity, positive predictive value and negative predictive value. Receiver Operating Characteristic (ROC) analysis and Area Under the Curve (AUC) will be presented to assess the overall discriminative performance.\]

  From initial clinical assessment at presentation to histological diagnosis following appendicectomy, is up to 6 months

Study Arms (1)

ELHT Patient Population

All emergency patients of any gender and aged 16 and above who were admitted between June 2023 and June 2024 with a clinical suspicion of acute appendicitis and who subsequently underwent an appendicectomy (via laparoscopy, open surgery, or laparotomy).

Eligibility Criteria

• Age: 16 Years+
• Sex: all
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All emergency patients of any gender and aged 16 and above who were admitted between June 2023 and June 2024 with a clinical suspicion of acute appendicitis and who subsequently underwent an appendicectomy (via laparoscopy, open surgery, or laparotomy).

You may qualify if:

• Patients of any gender
• Patients aged 16 and above
• Admitted as an emergency with suspected appendicitis
• Must have undergone appendicectomy (laparoscopic, open, or laparotomy) from June 2023 to June 2024 at East Lancashire Hospitals NHS Trust

You may not qualify if:

• Patients who have undergone elective, interval, or incidental appendicectomies.
• Patients younger than 16

Sponsors & Collaborators

• East Lancashire Hospitals NHS Trust: lead

Study Sites (1)

East Lancashire Hospitals NHS Trust

Blackburn, Lancashire, BB2 3HH, United Kingdom

Location

MeSH Terms

Conditions

Appendicitis

Condition Hierarchy (Ancestors)

Intraabdominal Infections; Infections; Gastroenteritis; Gastrointestinal Diseases; Digestive System Diseases; Cecal Diseases; Intestinal Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 10, 2026
• First Posted: September 4, 2026
• Study Start: April 13, 2026
• Primary Completion: July 28, 2026
• Study Completion: July 28, 2026
• Last Updated: September 4, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)