Accuracy of lintula score versus alvarado score in diagnosis of acute appendicitis in Al-yarmouk teaching hospital

Abstract

Background: Acute appendicitis is a common and urgent surgical illness with different manifestations, generous overlap with other clinical symptoms. Alvarado score uses mainly clinical findings and laboratory values to assess the presence of acute appendicitis. Lintula scoring system has the inherent advantage in that it does not require laboratory parameters. Aim of study: To compare between two applied scoring systems (Alvarado and Lintula) in the diagnosis of acute appendicitis. Methods: A prospective observational study that was conducted in the Department of General Surgery at Al-Yarmouk Teaching Hospital/Baghdad during the period of 10 months from 1st of April 2019 till 1st of February 2020. It included 160 patients attended the outpatient clinic or the emergency department with signs and symptoms suggestive of acute appendicitis.Results: In this study, most of the patients (88.8%) were underwent open appendectomy and follow up after discharge. More than half of the operated cases (95.8%) were diagnosed as acute appendicitis. Cut-off point of lintula scoring system was (21), so lintula score > 21 is predictive for diagnosis of appendicitis. Lintula scoring system was 67% sensitive, 58.3% specific, and 63.1% accurate. Cut-off point of Alvarado scoring system was (7), so Alvarado score > 7 is predictive for diagnosis of appendicitis. Alvarado scoring system was 82.7% sensitive, 55% specific, and 77.9% accurate. Conclusion: Lintula score is comparable to Alvarado score in sensitivity, specificity, and accuracy for the diagnosis of acute appendicitis. Lintula score is simple, non-invasive way to be used in resource limited conditions, but Alvarado score is still more statistically better than Lintula score.