Escalas Diagnósticas de Apendicitis Aguda en Adultos. Revisión sistemática de la literatura

Introduction: The use of scales predictive of acute appendicitis is key to guide early surgical management and treatment to reduce complications in adult patients. Given the lack of comparative studies, we evaluated the existing scales in the literature based on their accuracy, clinical utility and applicability. Methods: Systematic review based on PRISMA guidelines. We included studies that evaluated or compared one or more scales, stratified risks, reported statistical measures of diagnostic performance, and confirmed results with histopathology or imaging. Results: Eleven articles were selected in which: AIR showed greater sensitivity, specificity and accuracy with respect to Alvarado and Lintula. RIPASA stood out for its high sensitivity, while Tzanakis showed greater specificity due to the use of ultrasound; Eskelien and Ohman offered intermediate performance. Alvarado and its modified version were the most studied, but with lower diagnostic performance. Conclusions: The AIR scale demonstrates greater utility than the RIPASA and Alvarado scales, in addition it increases its sensitivity with respect to the latter by including CRP as part of the scale parameters, which helps to discriminate possible cases of acute appendicitis based on risk stratification.