{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T17:36:44Z","timestamp":1794245804595,"version":"4.9.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-025-85791-9","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T17:08:37Z","timestamp":1736356117000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Diagnostic value of the MZXBTCH scoring system for acute complex appendicitis"],"prefix":"10.1038","volume":"15","author":[{"given":"Tianyi","family":"Ma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,8]]},"reference":[{"key":"85791_CR1","doi-asserted-by":"publisher","first-page":"1999","DOI":"10.1007\/s00268-021-06077-5","volume":"45","author":"DP Wickramasinghe","year":"2021","unstructured":"Wickramasinghe, D. P., Xavier, C. & Samarasekera, D. N. The Worldwide Epidemiology of Acute Appendicitis: an analysis of the Global Health Data Exchange Dataset. World J. Surg. 45, 1999\u20132008 (2021).","journal-title":"World J. Surg."},{"key":"85791_CR2","doi-asserted-by":"publisher","first-page":"1276","DOI":"10.12669\/pjms.37.5.4016","volume":"37","author":"MN Sajjad","year":"2021","unstructured":"Sajjad, M. N., Naumeri, F. & Hina, S. Non-operative treatment versus appendectomy for acute uncomplicated appendicitis: a randomized controlled trial. Pak J. Med. Sci. 37, 1276\u20131281 (2021).","journal-title":"Pak J. Med. Sci."},{"key":"85791_CR3","doi-asserted-by":"crossref","unstructured":"Falih Noori Alsubsiee, I. & Falih Noori Alsubsiee, A. Appendicectomy for Uncomplicated Simple Appendicitis: Is It Always Required? Surg. Res. Pract. 8848162 (2021).","DOI":"10.1155\/2021\/8848162"},{"key":"85791_CR4","doi-asserted-by":"crossref","unstructured":"Akbulut, S. et al. Prediction of Perforated and Nonperforated Acute Appendicitis using machine learning-based explainable Artificial Intelligence. Diagnostics (Basel)  13 (2023).","DOI":"10.3390\/diagnostics13061173"},{"key":"85791_CR5","doi-asserted-by":"crossref","unstructured":"Liang, D. et al. Development and validation of a deep learning and Radiomics Combined Model forDifferentiating complicated from uncomplicated Acute Appendicitis. Acad. Radiol. (2023).","DOI":"10.21203\/rs.3.rs-2286059\/v1"},{"key":"85791_CR6","doi-asserted-by":"crossref","unstructured":"Stroh\u00e4ker, J. et al. Predicting complicated appendicitis is possible without the use of sectional imaging\u2014presenting the NoCtApp score. Int. J. Colorectal Dis. 38 (2023).","DOI":"10.1007\/s00384-023-04501-x"},{"key":"85791_CR7","doi-asserted-by":"crossref","unstructured":"Xu, H. et al. Comparison of the efficacy and safety of antibiotic treatment and appendectomy for acute uncomplicated appendicitis: a systematic review and meta-analysis. BMC Surg. 23 (2023).","DOI":"10.1186\/s12893-023-02108-1"},{"key":"85791_CR8","doi-asserted-by":"publisher","first-page":"1907","DOI":"10.1056\/NEJMoa2014320","volume":"383","author":"C Collaborative","year":"2020","unstructured":"Collaborative, C. et al. A randomized trial comparing antibiotics with appendectomy for Appendicitis. N Engl. J. Med. 383, 1907\u20131919 (2020).","journal-title":"N Engl. J. Med."},{"key":"85791_CR9","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s13017-020-00306-3","volume":"15","author":"S Di Saverio","year":"2020","unstructured":"Di Saverio, S. et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J. Emerg. Surg. 15, 27 (2020).","journal-title":"World J. Emerg. Surg."},{"key":"85791_CR10","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s13017-023-00478-8","volume":"18","author":"B Afzal","year":"2023","unstructured":"Afzal, B. et al. Is it possible to predict the severity of acute appendicitis? Reliability of predictive models based on easily available blood variables. World J. Emerg. Surg. 18, 10 (2023).","journal-title":"World J. Emerg. Surg."},{"key":"85791_CR11","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s13017-021-00398-5","volume":"16","author":"HA Lin","year":"2021","unstructured":"Lin, H. A., Tsai, H. W., Chao, C. C. & Lin, S. F. Periappendiceal fat-stranding models for discriminating between complicated and uncomplicated acute appendicitis: a diagnostic and validation study. World J. Emerg. Surg. 16, 52 (2021).","journal-title":"World J. Emerg. Surg."},{"key":"85791_CR12","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1007\/s00261-020-02737-7","volume":"46","author":"HY Kim","year":"2021","unstructured":"Kim, H. Y. et al. Differentiation between complicated and uncomplicated appendicitis: diagnostic model development and validation study. Abdom. Radiol. (NY). 46, 948\u2013959 (2021).","journal-title":"Abdom. Radiol. (NY)"},{"key":"85791_CR13","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1093\/bjs\/znab287","volume":"108","author":"H Javanmard-Emamghissi","year":"2021","unstructured":"Javanmard-Emamghissi, H. et al. Antibiotics as first-line alternative to appendicectomy in adult appendicitis: 90-day follow-up from a prospective, multicentre cohort study. Br. J. Surg. 108, 1351\u20131359 (2021).","journal-title":"Br. J. Surg."},{"key":"85791_CR14","doi-asserted-by":"crossref","unstructured":"Messias, B. et al. Usefulness of serum sodium levels as a novel marker for predicting acute appendicitis severity: a retrospective cohort study. BMC Surg. 23 (2023).","DOI":"10.1186\/s12893-023-02224-y"},{"key":"85791_CR15","first-page":"872","volume":"29","author":"E \u00c7etinkaya","year":"2023","unstructured":"\u00c7etinkaya, E. et al. A new, simple marker for predicting complicated appendicitis in patients with normal white blood cell count indicator; LUC %. Ulusal Travma ve Acil Cerrahi Dergisi. 29, 872\u2013876 (2023).","journal-title":"Ulusal Travma ve Acil Cerrahi Dergisi"},{"key":"85791_CR16","doi-asserted-by":"crossref","unstructured":"Zeb, M. et al. Comparison of Alvarado score, appendicitis inflammatory response score (AIR) and Raja Isteri Pengiran Anak Saleha appendicitis (RIPASA) score in predicting acute appendicitis. Heliyon 9. (2023).","DOI":"10.1016\/j.heliyon.2023.e13013"},{"key":"85791_CR17","doi-asserted-by":"publisher","first-page":"231","DOI":"10.47717\/turkjsurg.2023.6124","volume":"39","author":"S Shams Ud Din","year":"2023","unstructured":"Shams Ud Din, S. et al. RIPASA versus Alvarado score in the assessment of acute appendicitis: a prospective study. Turk. J. Surg. 39, 231\u2013236 (2023).","journal-title":"Turk. J. Surg."},{"key":"85791_CR18","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1097\/MS9.0000000000000270","volume":"85","author":"IF Noori","year":"2023","unstructured":"Noori, I. F., Jabbar, A. S. & Noori, A. F. Clinical scores (Alvarado and AIR scores) versus imaging (ultrasound and CT scan) in the diagnosis of equivocal cases of acute appendicitis: a randomized controlled study. Annals Med. Surg. 85, 676\u2013683 (2023).","journal-title":"Annals Med. Surg."},{"key":"85791_CR19","doi-asserted-by":"crossref","unstructured":"Taib, A. G. et al. Appendicolith Appendicitis: should we be Operating Sooner? A Retrospective Cohort Study (Annals of the Royal College of Surgeons of England, 2023).","DOI":"10.1308\/rcsann.2023.0055"},{"key":"85791_CR20","first-page":"e31297","volume":"14","author":"MS Naeem","year":"2022","unstructured":"Naeem, M. S. et al. Accuracy of RIPASA and Lintula scores in diagnosing Acute Appendicitis using Surgical findings as the Gold Standard. Cureus 14, e31297 (2022).","journal-title":"Cureus"},{"key":"85791_CR21","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1002\/bjs.9773","volume":"102","author":"AJ Scott","year":"2015","unstructured":"Scott, A. J. et al. Risk stratification by the Appendicitis Inflammatory Response score to guide decision-making in patients with suspected appendicitis. Br. J. Surg. 102, 563\u2013572 (2015).","journal-title":"Br. J. Surg."},{"key":"85791_CR22","doi-asserted-by":"publisher","first-page":"12772","DOI":"10.1038\/s41598-024-63513-x","volume":"14","author":"I Males","year":"2024","unstructured":"Males, I. et al. Applying an explainable machine learning model might reduce the number of negative appendectomies in pediatric patients with a high probability of acute appendicitis. Sci. Rep. 14, 12772 (2024).","journal-title":"Sci. Rep."},{"key":"85791_CR23","doi-asserted-by":"publisher","first-page":"e0255253","DOI":"10.1371\/journal.pone.0255253","volume":"16","author":"K Fujiwara","year":"2021","unstructured":"Fujiwara, K. et al. Usefulness of several factors and clinical scoring models in preoperative diagnosis of complicated appendicitis. PLoS One. 16, e0255253 (2021).","journal-title":"PLoS One"},{"key":"85791_CR24","doi-asserted-by":"publisher","first-page":"3663","DOI":"10.1177\/0300060519856155","volume":"47","author":"M Akai","year":"2019","unstructured":"Akai, M. et al. Hyperbilirubinemia as a predictor of severity of acute appendicitis. J. Int. Med. Res. 47, 3663\u20133669 (2019).","journal-title":"J. Int. Med. Res."},{"key":"85791_CR25","doi-asserted-by":"publisher","first-page":"679","DOI":"10.17826\/cumj.1276128","volume":"48","author":"H Mutlu","year":"2023","unstructured":"Mutlu, H., Sert, E. T., Kokulu, K. & Uslu, Y. Systemic immune inflammation index may be a new powerful marker for the accurate early prediction of complications in patients with acute appendicitis. Cukurova Med. J. 48, 679\u2013685 (2023).","journal-title":"Cukurova Med. J."},{"key":"85791_CR26","first-page":"220","volume":"51","author":"CF Chong","year":"2010","unstructured":"Chong, C. F. et al. Development of the RIPASA score: a new appendicitis scoring system for the diagnosis of acute appendicitis. Singap. Med. J. 51, 220\u2013225 (2010).","journal-title":"Singap. Med. J."},{"key":"85791_CR27","doi-asserted-by":"publisher","first-page":"23","DOI":"10.4103\/2221-6189.369075","volume":"12","author":"G Yildiz","year":"2023","unstructured":"Yildiz, G., Selvi, F., Bedel, C. & Zortuk, O. Systemic inflammation response index and systemic immune-inflammation index for predicting complications of acute appendicitis: a retrospective study. J. Acute Disease. 12, 23\u201328 (2023).","journal-title":"J. Acute Disease"},{"key":"85791_CR28","doi-asserted-by":"crossref","unstructured":"Kaewlai, R. et al. Validation of scoring systems for the prediction of complicated appendicitis in adults using clinical and computed tomographic findings. Insights into Imaging 14 (2023).","DOI":"10.1186\/s13244-023-01540-4"},{"key":"85791_CR29","doi-asserted-by":"publisher","first-page":"448","DOI":"10.4328\/ACAM.21608","volume":"14","author":"F Yildirim","year":"2023","unstructured":"Yildirim, F., Ucaner, B. & Hancerliogullari, O. The correlation between computed tomography reports and histopathological results in acute appendicitis. Annals Clin. Anal. Med. 14, 448\u2013453 (2023).","journal-title":"Annals Clin. Anal. Med."},{"key":"85791_CR30","doi-asserted-by":"publisher","first-page":"1755","DOI":"10.1177\/02841851221141221","volume":"64","author":"M Ak\u00e7i\u00e7ek","year":"2023","unstructured":"Ak\u00e7i\u00e7ek, M., Ilgar, M. & \u00dcnl\u00fc, S. Is acute appendicitis complicated or uncomplicated? Approaching the question via computed tomography. Acta Radiol. 64, 1755\u20131764 (2023).","journal-title":"Acta Radiol."},{"key":"85791_CR31","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1016\/S0196-0644(86)80993-3","volume":"15","author":"A Alvarado","year":"1986","unstructured":"Alvarado, A. A practical score for the early diagnosis of acute appendicitis. Ann. Emerg. Med. 15, 557\u2013564 (1986).","journal-title":"Ann. Emerg. Med."},{"key":"85791_CR32","doi-asserted-by":"crossref","unstructured":"Pogorelic, Z. et al. Validity of Appendicitis Inflammatory response score in distinguishing perforated from Non-perforated Appendicitis in Children. Child. (Basel) 8. (2021).","DOI":"10.3390\/children8040309"},{"key":"85791_CR33","doi-asserted-by":"publisher","first-page":"592892","DOI":"10.3389\/fped.2020.592892","volume":"8","author":"C Stiel","year":"2020","unstructured":"Stiel, C. et al. The Modified Heidelberg and the AI Appendicitis score are Superior to current scores in Predicting Appendicitis in children: a two-Center Cohort Study. Front. Pediatr. 8, 592892 (2020).","journal-title":"Front. Pediatr."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-85791-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-85791-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-85791-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T18:05:20Z","timestamp":1736359520000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-85791-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,8]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["85791"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-85791-9","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,8]]},"assertion":[{"value":"9 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This study was conducted in accordance with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Ethical approval was waived by the Ethics Committee of Tsinghua Changgung Hospital due to the retrospective nature of the study. Written informed consent was waived due to the retrospective nature of this study by the Ethics Committee of Tsinghua Changgung Hospital.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}],"article-number":"1366"}}