Calculators & Tools

AIR Score (Appendicitis Inflammatory Response)

Inflammation-weighted appendicitis score, useful for risk stratification.

1 What is the AIR Score (Appendicitis Inflammatory Response)?

The AIR Score (Appendicitis Inflammatory Response) is a GI & Liver scoring tool used in paediatric practice. Inflammation-weighted appendicitis score, useful for risk stratification. It scores 7 criteria and interprets the total across 3 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in GI & Liver
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 7 criteria: Vomiting; Pain in the right iliac fossa; Rebound tenderness or muscular defence; Body temperature ≥ 38.5 °C; Polymorphonuclear leucocytes; White blood cell count; C-reactive protein. Totals are then banded: any score - Low probability: aIR 0-4 - low probability. Outpatient follow-up if the patient is well; consider discharge with review; 5 points or more - Indeterminate: aIR 5-8 - indeterminate group. Admit for observation, serial examination and/or imaging; 9 points or more - High probability: aIR 9-12 - high probability of appendicitis. Surgical exploration is generally indicated.
  • Total range 0-12. Performs well in children and adults, particularly for advanced appendicitis.
  • Source: Andersson M, Andersson RE. The appendicitis inflammatory response score. World J Surg 2008;32:1843-9.

4 Frequently asked questions

How many criteria does the AIR Score (Appendicitis Inflammatory Response) use?

7. They are Vomiting; Pain in the right iliac fossa; Rebound tenderness or muscular defence; Body temperature ≥ 38.5 °C; Polymorphonuclear leucocytes; White blood cell count; and others.

What do the bands of the AIR Score (Appendicitis Inflammatory Response) mean?

The total is interpreted as: any score - Low probability: aIR 0-4 - low probability. Outpatient follow-up if the patient is well; consider discharge with review; 5 points or more - Indeterminate: aIR 5-8 - indeterminate group. Admit for observation, serial examination and/or imaging; 9 points or more - High probability: aIR 9-12 - high probability of appendicitis. Surgical exploration is generally indicated.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

Total range 0-12. Performs well in children and adults, particularly for advanced appendicitis.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.