In order to calculate the score, you need information on patient’s symptoms (pain in right lower quadrant (RLQ), migration of pain, and duration of symptoms). Physical examination findings include RLQ tenderness and level of muscular defense or guarding in RQL (no guarding, mild guarding, moderate or severe guarding). Laboratory test should include blood leukocyte count, blood neutrophil count and plasma C-reactive protein (CRP). Patient’s gender and age of female patients is also needed for the calculation of the score. The score needs that all variables are provided in order to get appropiate result.
The Score and the risk of appendicitis
0 – 10: low risk of appendicitis. Diagnostic imaging has limited value. Consider discharge or clinical observation only. If a patient has a very short duration of symptoms, observation and reassessment with new scoring after 8 to 12 hours is recommended.
11-15: possible appendicitis. Diagnostic imaging is recommended to confirm or rule out the diagnosis of appendicitis. Use ultrasound or computed tomography.
16 or higher: high probability of appendicitis. Patient may be operated on without preoperative imaging. Diagnostic imaging may be used in patients with atypical symptoms or suspicion of abscess or other disease.