APPEND score

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

Criteria ¹

• male gender (1)
• anorexia (1)
• migratory pain (1)
• localized peritonism (1)
• elevated CRP > 15mg/L (1)
• neutrophilia >7.5x10⁹/L (1)

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.