Application of alvarado scoring system in diagnosis of acute appendicitis
Keywords:Acute Appendicitis, Alvarado score, Appendectomy
Acute appendicitis is a common cause of abdominal pain and can be difficult to diagnose, especially during the early stages. There is still appreciable morbidity and occasionally mortality which may be related to the failure of making an early diagnosis (1)
As a result of their concern these surgeons create for themselves 'a surgical security zone which allows them to accept a 15-30% negative laparotomy rate with impunity (2), Although various aids exist to facilitate more accurate diagnosis and reduce the rate of negative appendectomy, many are complex.
Whereas simple scoring systems have been available for some time, they have not been widely tested.
The aim of this study was conducted to assess one of these scoring systems which were described by Alvarado in 19851(1), by comparing it to the histopathology results of operated patients.
This retrospective study of consecutive patients admitted to the surgical ward at Benghazi Aljala hospital with suspicion of having acute appendicitis during the period of January 2008 to January 2010.
The Alvarado scoring system was computed from admission notes and records correlated with histopathology, all cases with insufficient data or no histopathology result were excluded from the study
Out of 153 patients, 90 underwent appendectomy with the intention to treat appendicitis and diagnosis was confirmed in 80 patients. The reliability of the system was assessed by calculating the negative appendectomy rate and positive predictive value which was 85%, and the normal appendectomy frequency was 12%.
Alvarado scoring system is an easy, cheap, and useful tool in the preoperative diagnosis of acute appendicitis and can work effectively in routine practice.
Alvarado A. A practical score for the early diagnosis ofacute appendicitis. Ann Emerg Med 1986
Cuschieri A. The small intestine and vermiform appendix; In: Cuscheri A, G R Giles, A R Mossa.(ed). Essential surgical practice. 3rd ed. London: Butter worth Heinman. 1995
Pal KM, Khan A. Appendicitis, a continuing challenge. J Pak Med Assoc 1998
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 2000
Bailey And Love's Short Practice of Surgery 26th Edition
Sabiston textbook of surgery 19th edition
Kalan M, Talbot D, Cunliffe WJ, Rich AJ. Evaluation of the modified Alvarado score in the diagnosis of acute appendicitis: a prospective study. Ann R Coll Surg 1994.
Ohmann C, Yang Q, Franke C: the abdominal pain study group. Diagnostic scores for acute appendicitis. Eur J Surg 1995.
Gilmore OJA, Jones D, Ynag Q. Appendicitis and mimicking conditions. Lancet 1975.
Alverado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med 1986.
Jawaid A, Asad A, Motiei A, et al. Clinical scoring system: a valuable tool for decision making in cases of acute appendicitis. J Pak Med Assoc. 1999
Singh Kailash, Gupta Shyam, Pargal Pinki. Application of Alvarado Scoring System in Diagnosis of Acute Appendicitis. JK Science Journal of Medical Education and Research. 2008 Apr-June;10(2): 84-86
J Ayub Med Coll Abbottabad 2005;17(3) application of alvarado scoring system in diagnosis of acute appendicitis Ikramullah Khan, Ata ur Rehman department of surgery , surgical B unit , Khyber Teaching Hospital , Peshawar, Pakistan.
continuing diagnostic challenge of acute appendicitis: evaluation through modified alvarado score July 1998 DOI: 10.1111/j.1445-2197.1998.tb04811.x
Baidya N, Rodrigues G, Rao A, et al (2007) Evaluation of Alvarado score in acute appendicitis: a prospective study. Internet J Surg 9
Chan MY, Teo BS, Ng BL. The Alvarado score and acute appendicitis. Ann Acad Med Singapore. 2001
Khan I, ur Rehman A. Application of Alvarado scoring in diagnosis of acute appendicitis. J Ayub Med Coll Abbottabad. 2005
Ohmann C, Yang Q, Franke C. The abdominal pain study group. Diagnostic scores for acute appendicitis. Eur J Surg. 1995
Abdeldaim Y, Mahmood S, Mc Avinchey D. The Alvarado score as a tool for diagnosis of acute appendicitis. Ir Med J. 2007.Awoke N, Tekaligna T, Teshomea M, Lolasob T, Dendirc G, Suleiman M (2021). Bacterial Profile and asymptomatic bacteriuria among pregnant women in Africa: A systematic review and meta-analysis. Clinical Medicine. 1, pp. 1-8