APPEND score

Last revised by Calum Worsley on 16 Feb 2023

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


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

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