APPLICATION OF ALVARADO SCORING SYSTEM IN DIAGNOSIS OF ACUTE APPENDICITIS
Abstract
Background: In conditions like acute appendicitis it is impractical to have definitive diagnosis bygold standard test (histopathology) before surgery, we would like a simple test like Alvaradoscoring system which depends on the presence and absence of certain variables and whichprovides an accurate guide to whether or not the patient has the condition. This study wasconducted to evaluate Alvarado scoring system for the diagnosis of acute appendicitis in our setup. Methods: 100 consecutive patients with suspected acute appendicitis admitted in Surgical Bunit, Khyber Teaching Hospital Peshawar, during the period from July to December 2003 wereincluded in the study. They were given specific scores according to the variables of Alvaradoscoring system and then divided into 3 groups. Group 1 patients (score 7 or more) underwentsurgery, group 2 patients (score 5-6) were admitted for observation and group 3 patients (score 4or less) were discharged home. Patients from group 2 with increased symptom intensity (score 7or more) in reevaluation underwent surgery. Diagnosis was confirmed by histopathologicalexamination. Reliability of scoring system was assessed by calculating negative appendicectomyrate and positive predictive value. Results: Out of a total 100 patients 64 patients underwentsurgery and appendicitis was confirmed in 54 cases, thus giving negative appendicectomyfrequency of 15.6% (male 12%, female 17.9%). Perforation rate was 7.8%. Positive predictivevalue was 84.3% (males 88%, females 82.1%). Conclusion: This scoring system is easy, simpleand cheap complementary aid for supporting the diagnosis of acute appendicitis especially forjunior surgeons.Key words: Acute appendicitis, Appendicectomy, Scoring system.References
Stephens PL, Mazzucco JJ. Comparison of ultrasound and the Pak 2000;10:392-4.
Alvarado score for the diagnosis of acute appendicitis. Conn
Med 1999;63:137-40.
Arian GM, Sohu KM, Ahmad E, Haider W, Naqi SA. Role of
Alvarado score in diagnosis of acute appendicitis. Pak J Surg
Cuschieri A. The small intestine and vermiform appendix; In: 2001;17:41-6.
Cuscheri A, G R Giles, A R Mossa.(ed). Essential surgical
practice. 3rd ed. London: Butter worth Heinman. 1995;1325-8
Owe TD, Williams H, Stiff G, Jenkinson LR, Rees BI.
Evaluation of the Alvarado score in acute appendicitis. J R Soc
Pal KM, Khan A. Appendicitis, a continuing challenge. J Pak Med 1992;85:87-8.
Med Assoc 1998;48:189-92. 16. Shrivastava UK, Gupta A, Sharma D. Evaluation of the
Alvarado score in the diagnosis of acute appendicitis. Trop
Gastroenterol 2004;25:184-6.
Kumar V, Cotran RS, Robbins SL. Appendix; In Robbin’s
Basic Pathology. 5th ed. London:W.B Saunders 1992; 520
Dado G, Anania G, Baccarani U, Marcotti E, Donini A,
Risaliti A et al. Application of a clinical score for the diagnosis
of acute appendicitis in childhood. J Pediatr Surg
;35:1320-2.
Sadiq M, Amir S. Efficacy of modified Alvarado scoring
system in the diagnosis of acute appendicitis. J Postgrad Med
Inst 2002;16:72-7.
Rehman I, Burki T. Alvarado scoring system in the diagnosis
of acute appendicitis in children. J Med Sci 2003;11:37-41.
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.