Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
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    Patent Pending

    Appendicitis Inflammatory Response (AIR) Score

    Diagnoses appendicitis based on clinical and laboratory findings.
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    INSTRUCTIONS

    Use in pediatric or adult patients with suspected appendicitis (large external validation cohort included ages 2-96 years).
    When to Use
    Pearls/Pitfalls
    Why Use

    Use in pediatric or adult patients with suspected appendicitis (large external validation cohort included ages 2-96 years).

    Requires C-reactive protein value, which is sometimes not part of the routine battery of tests for abdominal pain.

    • Outperforms the Alvarado Score in a large (n = 941 consecutive patients) external validation cohort (De Castro 2012) with an AUROC of 0.96.
    • May help avoid the need for CT imaging.

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    For patients with an indeterminate AIR Score, clinician judgment should prevail.

    Formula

    Addition of selected points:

    Vomiting

    No

    0

    Yes

    +1

    RIF pain

    No

    0

    Yes

    +1

    Rebound tenderness

    None

    0

    Light

    +1

    Medium

    +2

    Strong

    +3

    Temp ≥101.3ºF (38.5ºC)

    No

    0

    Yes

    +1

    Polymorphonuclear leukocytes

    <70%

    0

    70–84%

    +1

    ≥85%

    +2

    WBC count, ×109/L

    <10

    0

    10.0–14.9

    +1

    ≥15

    +2

    CRP level, g/L

    <10

    0

    10–49

    +1

    ≥50

    +2

    Facts & Figures

    Interpretation:

    AIR Score

    Risk

    Recommendation

    0–4

    Low

    Outpatient follow-up (if unaltered general condition)

    5–8

    Indeterminate

    In-hospital active observation with serial re-exams, imaging, or diagnostic laparoscopy, according to local practice

    9–12

    High

    Surgical exploration

    Dr. Manne Andersson

    About the Creator

    Manne Andersson, MD, is a vascular surgeon in the department of clinical and experimental medicine and the division of surgery, orthopedic and oncology at Linköping University in Linköping, Sweden. Dr. Andersson’s research interests include gangrenous appendicitis and acute appendicitis diagnostic tools.

    To view Dr. Manne Andersson's publications, visit PubMed