Evaluation of Alvarado Scoring System in Preoperative Diagnosis of Acute Appendicitis

Title: Evaluation of Alvarado Scoring System in Preoperative Diagnosis of Acute Appendicitis

Authors: Ashish Agrawal, Anil Baxi, Prateek Porwal, Abhishek Verma, Naveen Sharma

DOI: https://dx.doi.org/10.18535/jmscr/v4i12.43

Abstract

Background: Aim of the study was to evaluate Alvarado scoring system in preoperative diagnosis of Acute Appendicitis and to compare clinical diagnosis and Alvarado scoring for early diagnosis and correlate them with histopathological findings in case of acute appendicitis.

Material and Method: The present study is carried out in 100 cases of appendicitis admitted in of Index Medical College, Hospital and Research Centre, Indore during the period from January 2015 to June 2016 (18 months) . Calculation of Alvarado score done on the basis of signs symptoms and Laboratory findings of patients admitted in IMCHRC during the course of the study. Confirmation of diagnosis by histopathological correlation.

Result: We concluded our study in 100 consecutive patients with clinical features of acute appendicitis among them 32were females and 68 were males. Male to female ratio 2.12:1. Most of the patients belong to younger age group (43% in age group of 21-30 years). Mean scores for the emergency surgery group, and observation group were 7-10 and 5-6 respectively .Negative appendectomy rate in our study was 32.9% out of which among males it is lesser (31.57%) as compared to females who had a higher Negative appendectomy rate of 35.7%. Sensitivity of Alvarado score ≥7 was 92.9% and specificity was 78.5%. Positive and Negative value of Alvarado score ≥7 was 89.8% and84.6% respectively.

Conclusion: Acute Appendicitis was definitely absent among 28 operated cases. This rate of 32.9% was by no means high when compared to the reported range of 8- 33% in the literature but certainly not enough to make its adoption recommendable.

Keywords: Acute Appendicitis, Alvarado scoring.

References

1. Lewis FR, Holcroft JW, Boey J, et al: Appendicitis: A critical review of diagnosis.

2. Mohamed AA and Bhat NA. Acute appendicitis dilemma of diagnosis and management. The internet journal of surgery 2010; 23(2), DOI: 10.5580/18e0.

3. Fung HS, Lau S, Siu JCW, Chan CM, Chan SCH. Audit of ultrasonography for diagnosis of acute appendicitis: a retrospective study. J HK Coll Radiol. 2008; 11:108-111.

4. Tamanna MZ, Eram U, Hussain AM, Khateeb SU, Buhary BM. Alvarado score in diagnosis of acute appendicitis. International Journal of Basic and Applied Medical Sciences 2012; 2(1):66-70.

5. Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med.1986;15:557–564.

6. Ohle R, O’Reilly F, O’Brien KK, Fahey T, Dimitrov BD. The Alvarado score for predicting acute appendicitis: a systematic review. BMC Med. 2011;9:139

7. Heinrik Jahan, Claus P., Hovendal Department of Surgery, Odense University Hospital, Odense, Denmark : Comparison of clinical judgement and diagnostic USG in the diagnosis of acuteappendicitis experience with a score aided diagnosis.

Corresponding Author

Ashish Agrawal

Department of Surgery, IMCHRC, Indore

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