Boğaz Ağrısında Mıstık Skoru ve Modifiye Centor Skoru’nun Kullanımının Değerlendirilmesi

Year 2021, , 122 - 129, 11.03.2021

Humeyra Aslaner , Selçuk Mıstık , Gözde Ertürk Zararsız , Hüseyin Kılıç , Neriman Çetin Benli

https://doi.org/10.18521/ktd.839462

Abstract

Amaç: Akut tonsillofarenjitte, kullanılan çeşitli klinik skorlamalar mevcuttur. Streptokoksik farenjitini öngörmek için Modifiye Centor Skoru ve viral ajanlara tanı koymak için Mıstık Skoru geliştirilmiştir. Bu çalışma da birinci basamakta boğaz ağrısı şikayeti ile gelen hastaların hızlı antijen testi (HAT) sonuçlarına göre Modifiye Centor Skoru ve Mıstık Skoru’nun cutoff noktalarının belirlenmesi ve aile hekimleri tarafından kullanımının değerlendirilmesi amaçlandı.

Gereç ve Yöntem: Aile sağlığı merkezlerine boğaz ağrısı şikayeti ile başvuran 3-80 yaş arasındaki 125 hasta dahil edildi. Hastaların fizik muayeneleri yapılıp Mıstık Skoru ve Modifiye Centor Skor’ları tespit edildi. Hastalara HAT uygulandı, verilen tedavi kaydedildi. Çalışmanın 2. aşamasında hastalara klinik skorlama uygulanıp Mıstık Skoru, Modifiye Centor Skoru ve HAT kullanımının değerlendirilmesi için doktorlara anket uygulandı.

Bulgular: Modifiye Centor Skoru için en uygun kesim noktası 3 olup duyarlılığı %87.5 ve seçiciliği %86.2, pozitif kestirim değeri %48.3, negatif kestirim değeri %97.9 bulunmuştur. Mıstık Skoru için en uygun cutoff değeri 3 olup duyarlılığı %61 ve seçiciliği %87.5, pozitif kestirim değeri %97, negatif kestirim değeri %25 bulunmuştur. Aile hekimlerinin %75’i klinik skorlamayı rutin muayenede kullanıyordu ve en çok kullanılan skorlama yöntemi de ModifiyeCentor Skoru idi (%88.9). Aile hekimlerinin %75’i HAT’ a karar vermeden önce klinik skorlama kullanmaktadır.

Sonuç: Günlük aile hekimliği pratiğinde çok sık görülen boğaz ağrısında Mıstık Skoru, Modifiye Centor Skoru gibi klinik skor kullanımı öncelikle HAT testinin uygun hastada yapılmasını sağlayacaktır. İlaveten aile hekimlerinin tonsillofarenjit konusunda daha uygun tedavi kararları vermesini sağlayacaktır. Bu yüzden klinik skorlamaların kullanımını ve özellikle viral bir skorlama olan Mıstık Skoru’nun kullanımını önermekteyiz.

Keywords

Boğaz ağrısı, Mıstık Skoru, Modifiye Centor Skoru, Hızlı Antijen Testi

Supporting Institution

Erciyes Üniversitesi Bilimsel Araştırma Projeleri Koordinatörlüğüne (BAP)

Project Number

Proje no. TTU-2018-8131

Evaluation of the Use of the Mistik Score and Modified Centor Score in Sore Throat

Abstract

Objective: There are various clinical scoring systems in acute tonsillopharyngitis. The Modified Centor Score was developed to predict streptococcal pharyngitis and the Mistik score was developed to diagnose viral agents. This study aimed to determine cut-off values of the Modified Centor Score and Mistik score according to rapid antigen detection test (RADT) results of patients admitted with sore throat in the primary care and evaluate the use of these scoring systems by family physicians.

Methods: A total of 125 patients between the ages of 3 and 80 who were admitted with sore throat to the family health centers were included in the study. Physical examinations of the patients were performed and their Mistik and Modified Centor Scores were detected. Patients underwent RADT. Treatments of the patients were recorded. In the second stage of the study, patients underwent clinical scoring and the physicians completed a questionnaire to evaluate the use of the Mistik Score, Modified Centor Score and RADT.

Results: The optimal cut-off value for the Modified Centor Score was 3, sensitivity was 87.5%, specificity was 86.2%, positive predictive value was 48.3% and negative predictive value was 97.9%. The optimal cut-off value for Mistik score was 3, sensitivity was 61%, specificity was 87.5%, positive predictive value was 97% and negative predictive value was 25%. Of the physicians, 75% used clinical scoring during routine examination and the most common scoring system used was the Modified Centor Score (88.9%). Of the physicians, 75% used clinical scoring before the decision of RADT.

Conclusion: The use of clinical scoring systems such as the Mistik Score and Modified Centor Score will primarily allow RADT be used in the appropriate patient for sore throat that is very common in daily family practice. In addition, it will help family physicians decide on the best treatment options for tonsillopharyngitis. Therefore, we recommend the use of clinical scoring systems especially the Mistik Score, which is a viral scoring system.

Keywords

Sore Throat, The Mistik Score, The Modified Centor Score, Rapid Antigen Detection Test

Project Number

Proje no. TTU-2018-8131

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