A study of Alvarado score and its correlation with acute appendicitis

Abstract

Background: Scoring systems are valuable and valid for discriminating between acute appendicitis and nonspecific abdominal pain. Alvarado scoring system is one of the many scoring systems available for the diagnosis of acute appendicitis and is purely based on history, clinical examination and few laboratory tests and is very easy to apply. The objectives of the study were to evaluate efficacy of Alvarado scoring system in preoperative diagnosis of acute appendicitis and correlating it with postoperative findings. Methods: The present study was a prospective study of 50 patients presenting with symptoms and signs of acute appendicitis to the emergency department during a period of 2 years. Patients who met the inclusion criteria were evaluated using Alvarado scoring system. All the patients were operated by conventional method of open appendicectomy. The efficacy of Alvarado scoring system was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value and negative appendicectomy rate. Results: Pain was the most common presenting symptom (100%). Time of presentation ranged from 1-7 days with a mean of 1.98 days. Out of 50 patients, 35 (70%) are in the score range of 7-10, 12 (24%) in the score range of 5-6 and 3 (6%) in the 1-4 group. Appendix was inflamed in 86% cases. In the present study, negative appendicectomy rate was 14%. Conclusions: Alvarado scoring system is an easy, simple, cheap, reliable and safe tool in pre operative diagnosis of acute appendicitis and can work effectively in routine practice.