Appendicitis Inflammatory Response (AIR) Score

Why Use

Outperforms the Alvarado Score in a large (n = 941 consecutive patients) external validation cohort ( De Castro 2012 ) with an AUROC of 0.96. May help avoid the need for CT imaging.

When to Use

Use in pediatric or adult patients with suspected appendicitis (large external validation cohort included ages 2-96 years).

Formula

Pearls / Pitfalls

Requires C-reactive protein value, which is sometimes not part of the routine battery of tests for abdominal pain.

Advice

For patients with an indeterminate AIR Score, clinician judgment should prevail.

More Information

Interpretation: AIR Score Risk Recommendation 0–4 Low Outpatient follow-up (if unaltered general condition) 5–8 Indeterminate In-hospital active observation with serial re-exams, imaging, or diagnostic laparoscopy, according to local practice 9–12 High Surgical exploration