Acute appendicitis is one of the most common surgical emergencies, but diagnostic uncertainty may still lead to unnecessary appendectomy in some patients. This prospective observational study aims to evaluate the diagnostic performance of computed tomography (CT) reporting and the Appendicitis Inflammatory Response (AIR) score in adult patients undergoing appendectomy for suspected acute appendicitis. The primary objective is to determine the negative appendectomy rate based on final histopathology. Secondary objectives are to assess the agreement between AIR score, CT findings, intraoperative severity grading, and pathology results, and to explore diagnostic performance across patient subgroups. No study-specific intervention beyond routine clinical care will be performed.
Age 18 years or older
Presentation to the emergency department with suspected acute appendicitis
Underwent computed tomography after clinical evaluation
Computed tomography report compatible with acute appendicitis
Age younger than 18 years
Pregnancy
Planned additional surgical intervention in the same session for a reason other than appendicitis
Intraoperative finding of a non-appendiceal pathology requiring a different surgical procedure
Adult patients presenting to the emergency department with suspected acute appendicitis who undergo computed tomography after clinical evaluation, have a CT report compatible with acute appendicitis, and subsequently undergo appendectomy at Sanliurfa Education and Research Hospital.
Cohort
Prospective
Not listed
Diagnostic agreement between CT report and final histopathology
Concordance between computed tomography findings reported as compatible with acute appendicitis and final histopathologic diagnosis.
Negative appendectomy rate
The proportion of patients who undergo appendectomy but whose final histopathologic examination does not confirm acute appendicitis.
Agreement between AIR score and final histopathology
Association between the Appendicitis Inflammatory Response (AIR) score and histopathologic confirmation of acute appendicitis.
Agreement between intraoperative AAST grading and final histopathology
Concordance between intraoperative appendicitis severity grading based on the AAST classification and final histopathologic findings.
Comparative diagnostic performance of CT report and AIR score
Comparison of the diagnostic performance of computed tomography reporting and AIR score in predicting histopathologically confirmed acute appendicitis.
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