Evaluation of Accuracy and Predictability of Tzanakis score in Diagnosis of Acute Appendicitis

Author(s): Dharminder Nirwan and Jyoti Dabi

The Tzanakis scoring system is a thorough method that integrates clinical assessment, ultrasonography, and laboratory indicators of inflammatory response. It serves as a reliable tool for accurately diagnosing acute appendicitis. The main objective of this study was to assess the effectiveness of the Tzanakis scoring system in the preoperative diagnosis of acute appendicitis and compare its accuracy with histopathological examination (HPE). This study was conducted in the Department of General Surgery, at a tertiary care center in North India. All patients with a clinical diagnosis of acute appendicitis were included in the study. Following a thorough clinical assessment, as well as radiological and laboratory tests, the score of Tzanaki was calculated, and the final diagnosis was confirmed through the HPE report. There are four variables of Tzanakis score (right lower quadrant tenderness-4 points, rebound tenderness-3 points, total leucocyte count more than 12000-2 points, positive ultrasound finding-6 points). 50 patients, clinically diagnosed as cases of acute appendicitis in the study were histopathologically examined, 39 cases were acute appendicitis, 07 were chronic appendicitis and 04 were normal. The Sensitivity, Specificity, negative predictive value, and positive predictive value are 86.5%, 75%, 33.33%, and 97.56%. The overall diagnostic accuracy of Tzanakis score is 86%. The Tzanakis scoring system is an effective modality to establish the accurate diagnosis of acute appendicitis which requires surgery, especially in low-resource areas and helps in reducing the rates of negative appendicectomy