Evaluation and Comparison of the Accuracy and Efficacy of Alvarado and Appendicitis Inflammatory Response Scoring in Acute Appendicitis

Abstract

INTRODUCTION
 Acute appendicitis (AA) is one of the most common causes of acute abdominal pain. Early surgery for acute appendicitis may lead to inadequate evaluation of differential diagnoses of acute abdominal pain and increases the chances of negative appendectomy, whereas delaying it leads to potential complications. Appendicitis inflammatory response (AIR) score, has been created to overcome shortcomings of the Alvarado score. In this, a mathematical model focused on detecting perforated appendicitis has been used. Unlike previously reported scores, this included C-reactive protein (CRP), which had been previously reported to have high accuracy in discriminating between simple and advanced acute appendicitis.
 MATERIAL AND METHODS
 Observational Cross sectional study was done in all patients admitted to UCMS hospital diagnosed to have acute appendicitis from October 2019 to March 2021. The primary objective was to determine if use of Appendicitis Inflammatory Response Score is better suited for planning management of patients with acute appendicitis. Comparison between groups was done with one-way Analysis of Variance (ANOVA). Receiver Operating Curve (ROC) was used to identify whether Appendicitis inflam- matory response (AIR) score or Alvarado score was good predictor of acute appendicitis. Sensitivity, Specificity and Area under Curve (AUC) was used as indicators to predict the acute appendicitis.
 RESULTS
 In our study, the sensitivity of Appendicitis inflammatory response (AIR) score is high (85.4%) as compared to 82.3% of Alvarado score.
 CONCLUSION
 We concluded that Appendicitis inflammatory response (AIR) score is more reliable scoring system for the diagnosis of acute appendicitis and its use can be justified over the pre-existing Alvarado scoring.