The Role of the Speed Bump Sign Model for Diagnosing Acute Perforated Appendicitis in the Emergency Department Acil Serviste Akut Perfore Apandisit Tanısında Hız Kasis Bulgusu Modelinin Rolü
Anatolian journal of emergency medicine, cilt.8, sa.4, ss.158-164, 2025 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 8 Sayı: 4
- Basım Tarihi: 2025
- Doi Numarası: 10.54996/anatolianjem.1703603
- Dergi Adı: Anatolian journal of emergency medicine
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.158-164
- Anahtar Kelimeler: Acute appendicitis, diagnostic accuracy, perforated appendicitis, speed bump sign
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aim: Diagnostic strategies for acute appendicitis (AA), including physical examination, imaging, and laboratory analyses, remain challenging due to variable presentations. The speed bump sign (SBS), evaluating pain during transit, has been explored as a diagnostic indicator. Our study aimed to validate SBS and introduced an emergency department (ED)-based speed bump model (SBS-m) for diagnosing perforated appendicitis (PA). Material and Methods: Adult patients presenting with suspected acute appendicitis (AA) were enrolled. A speed bump model assessed the SBS-m. Positive SBS responses indicated heightened pain upon the rear wheelchair wheel's speed bump contact, while negative responses indicated no pain change. SBS and SBS-m were subsequently compared. Results: AA was diagnosed in 100 (82%) of 122 suspected cases. For diagnosing AA, SBS showed 81.4% sensitivity (95% CI: 72.3-88.6), while SBS-m had 82% sensitivity (95% CI: 73.1-88.9). Both tests displayed 100% sensitivity and NPV (95% CI: 76.8-100) in distinguishing PA from non-perforated AA. Conclusion: The SBS and SBS-m exhibit high sensitivity in diagnosing PA with minimal false negatives, suggesting their potential as valuable tools for PA exclusion.