New Score (Muzammil-Mudassar appendicitis severity score-an effective tool for conservative management of acute appendicitis.

Abstract

Objective: To determine the frequency of conservatively managed patients of acute appendicitis by using new (Muzammil-Mudassar appendicitis severity score) scoring system. Study Design: Cross Sectional Observational study. Setting: Government Teaching Hospital, Shahdara. Period: October 2021 to April 2022. Material & Methods: 267 patients diagnosed with acute appendicitis by ALVARADO score were enrolled. New appendicitis severity score was devised by searching online literature. A cut off value of 11 was defined after conducting a pilot study. Patients having score of < 11 were eligible for conservative management. All patients undergoing conservative treatment were receiving nothing per oral and given intravenous antibiotics (ciprofloxacin and metronidazole), intravenous fluids and infusion Paracetamol three times a day for at least 24-48 hours. Surgery was done in failed or unsatisfied cases. Weekly follow-up for first two weeks and then monthly for three months was done. Results: In our study mean age of the patients was 46.23±19.33 years, 187(70.04%) patients had age ≤60 years. The conservative management was successful in 214(80.15%) patients. Recurrence after three months was noted in 13(4.87%) patients. After 3 month follow up the anorexia was found in 4(1.5%) patients, nausea/vomiting in 5(1.9%) patients and pain was noted in 7(2.6%) patients. Conclusion: new score (Muzammil-Mudassar appendicitis severity score) is highly effective in predicting patients who will benefit from conservative management in terms of recurrence.