Evaluation of Modified Alvarado Score Compared with Histopathological Diagnosis in Acute Appendicitis

Abstract

Background: Decision-making in patients with acute appendicitis poses a diagnostic challenge worldwide, despite much advancement in abdominal surgery. A number of scoring systems have been advocated to minimize the number of negative appendectomies. However, Modified Alvarado Score System (MASS) is the most prominent and widely used one. Considering limited data regarding correlation between Modified Alvarado Score and post-operative histopathological findings, the study was designed to assess the usefulness of Modified Alvarado Score compared with histopathological report in diagnosis of acute appendicitis. Methods: This cross sectional observational study was conducted at the department of General Surgery, Mymensingh Medical College & Hospital, Mymensingh. All of the admitted patients with acute appendicitis were approached for inclusion of the study. All patients who met the inclusion criteria were consecutively enrolled in the study. Prior final inclusion, informed written consent form was ensured. Ethical issues were maintained in according to the Declaration of Helsinki. Appendicectomy was done based on the overall clinical judgement. Pre-operative Modified Alvarado Score was assessed for all patient. The diagnosis was confirmed by histopathological examination. Data was collected by the researcher(me) and total 106 patients were included. Following collection, all data were sorted, checked and verified. After that data analysis was done by using SPSS statistical computer software (version 22). Results: A total number of 106 patients were studied. Their ages ranged from 12 to 51 years (mean 26.38±7.49 SD). There were 73.6% males and 26.4% females. All patients in this study underwent appendicectomy. Majority respondents had Modified Alvarado Score more than or equal to 7 (84%) and 16% had score below 7. According to histopathology findings, 14.16% respondents had normal appendix with or without other pathology and 85.84% had acute appendicitis. ....