APPEND score

The APPEND score is a clinical decision rule and predictor of the likelihood of acute appendicitis.

Criteria

Each of the following are worth 1 point ¹:

• male gender

• anorexia

• migratory pain

• localized peritonism

• elevated CRP >15mg/L

• neutrophilia >7.5x10⁹/L

APPEND refers to the mnemonic:

• A: anorexia

• P: pain (migratory)

• P: peritonism (localized)

• E: elevated CRP

• N: neutrophilia

• D: dude (male)

Score total:

• 0-1: low risk of acute appendicitis

• 2-4: intermediate risk of acute appendicitis

• ​5-6: high risk of acute appendicitis

For a score of 1 (low risk of acute appendicitis), the NPV is 95.6% ².

For a score of 5 (high risk of acute appendicitis), the PPV is 95.5% ².

See also

• Alvarado score