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Receiver operator characteristic curve analysis of the Lintula score for reduction of negative appendectomies in adults.

OBJECTIVE
To evaluate the Lintula score in reducing negative appendectomies in the adult population.


STUDY DESIGN
Descriptive analytical study.


PLACE AND DURATION OF STUDY
Surgical Department, Khyber Teaching Hospital, Peshawar, Pakistan, from August 2012 to April 2014.


METHODOLOGY
A total of 408 emergency patients with a clinical diagnosis of acute appendicitis were included in the study. True or negative appendectomy status was determined per-operatively. Lintula score was calculated afterwards and evaluated for various cut-off points.


RESULTS
Among the study population, 72 (17.6%) had a normal appendix by operative assessment and 336 (82.4%) had an acutely inflammed appendix. The receiver operating characteristic curve showed that the optimal cut-off point was ≤ 21 with 100% sensitivity, 88.4% specificity and positive and negative predictive values of 97.3% and 100%, respectively. Area under the curve was 0.963 with 90.4% overall accuracy.


CONCLUSION
Utilizing the Lintula cut-off point of ≤ 21, negative appendectomies, unnecessary admissions and healthcare cost can all be reduced.