MODIFIED APPEND SCORE FOR THE DIAGNOSIS OF ACUTE APPENDICITIS IN A NEW ZEALAND PASIFIKA POPULATION renatopitesa@gmail.com

PW02-09

MODIFIED APPEND SCORE FOR THE DIAGNOSIS OF ACUTE APPENDICITIS IN A NEW ZEALAND PASIFIKA POPULATION

3

New Zealand

Oral or Poster

Diagnosing acute appendicitis often requires biochemical and imaging support which may not be feasible in low- and middle-income countries (LMICs). The APPEND score, developed in New Zealand, includes C-reactive protein (CRP) which in resource-limited settings, may be hindered by slow processing times. This study aims to evaluate a modified APPEND score (mAPPEND), excluding CRP for diagnosing appendicitis in a New Zealand Pasifika cohort.

This secondary analysis utilised data from two cohorts (2011 and 2017) from Middlemore Hospital, Auckland. Adults ≥ 15 years with < 7 days of right iliac fossa pain were included; prior appendicectomy or generalised peritonitis were excluded. Sensitivity, specificity, positive/negative predictive values (PPV/NPV) were calculated, and area under the receiver-operating-characteristic curve (AUC) were calculated for both scores.

Among 143 Pasifika patients, the AUC for the APPEND and mAPPEND scores were comparable (0.84 vs. 0.85 respectively, p = 0.41). The mAPPEND score demonstrated high diagnostic accuracy with scores between 1 and 2 showing high sensitivity (100% and 97%) and NPV (90% and 92%), scores 4-5 showing high specificity (94% and 100%, respectively) and PPV (90% and 100%, respectively), and a score of 3 being the most efficient with a sensitivity of 82% and specificity of 71%.

The mAPPEND score, maintains high diagnostic accuracy for appendicitis in a New Zealand Pasifika population. This modified score is a simple and viable tool in settings where CRP testing is unfeasible, supporting its use in Pacific Island countries.