Annals of Clinical and Analytical Medicine 1 Annals of Clinical and Analytical Medicine Original Research Baris Mantoglu 1 , Emre Gonullu 1 , Guner Cakmak 1 , Mertcan Akcay 1 , Merve Yigit 1 , Guven Erdogrul 2 , Kayhan Ozdemir 3 , Fatih Altıntoprak 4 1 Department of General Surgery, Sakarya University Training and Research Hospital, Sakarya 2 Department of General Surgery, Mersin City Training and Research Hospital, Mersin 3 Department of General Surgery, Urgup State Hospital, Urgup 4 Department of General Surgery, Sakarya University Faculty of Medicine, Sakarya, Turkey Appendicitis scoring systems To what extent are the appendicitis scoring systems efective in preventing negative appendectomy. Comparison of nine scoring systems DOI: 10.4328/ACAM.20932 Received: 2021-11-01 Accepted: 2021-12-06 Published Online: 2021-12-10 Corresponding Author: Baris Mantoglu, Department of General Surgery, Sakarya Training and Research Hospital, Sakarya, Turkey. E-mail: barismantoglu@gmail.com P: +90 505 815 93 79 Corresponding Author ORCID ID: https://orcid.org/0000-0002-2161-3629 Abstract Aim: Negative appendectomy is costly for both the patient and the health system; furthermore, it may introduce the patient to unnecessary surgical intervention and possible complications. This study aims to determine the most suitable one by comparing nine of the most popular appendicitis scoring systems. Material and Methods: The study included 170 patients who were histopathologically diagnosed with appendicitis in the last year (Group 1), and 143 patients without appendicitis in the last fve years (Group 2). The variables required to calculate scoring systems for the prediction of acute appendicitis were saved to the study datasheet, and each patient’s score was calculated for each scoring system with the formulated excel fle automatically. Results: Among all scoring systems, the Karaman score was most efcacious at predicting appendicitis. The positive predictive value of the Karaman score was 89.9%, whereas the negative predictive value was 57.9%. The Alvarado score performed the best among the scoring systems. This was associated with a positive predictive value of 89.5%, negative predictive value of 85.7%, and sensitivity and specifcity of 67.6% and 84.1%, respectively. Discussion: The use of suitable scoring systems with or without imaging modalities or may reduce negative appendectomy rates. Keywords Appendicitis, Appendectomy, Negative Appendectomy, Score