APPEND score

Last revised by Assoc Prof Craig Hacking on 09 Aug 2021

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.

See also

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