Abstract
Objective: to evaluate the diagnostic accuracy (discrimination) and implementation performance of Alvarado score. Methodology: This cross sectional study was done in Surgerical unit of Bahawal Victoria hospital Bahawalpur under supervision of consultant Surgeons of department. Study duration was 1 year from March 2018 to March 2019. For quantitative variables like age of patients Mean and SD was calculated, and frequency percentages were calculated for categorical data like gender. Negative appendectomy rate, positive predictive value, negative predictive value, sensitivity, specificity was calculated by using 2-2 contingency table. Results: Total 300patients enrolled in this study, both genders. Alvarado scoring at presentation, 15% (n=45) patients were categorized into Group I. 13% (n=39) patients were included in Group II. While, 72% (n=216) were enrolled in Group III. Diagnostic test was positive in 223 patients. While, acute appendicitis was confirmed histo-pathologically in 160 patients. Gangrenous appendicitis observed in 3 patients. Chronic appendicitis, perforated appendicitis, appendicular abscess, no specific pathology, gangrenous intestine and salpingo-oophoritis was observed as 31, 6, 9, 6,3 and 5 respectively. There were 174 patients true positive, 49 were false positive, 59 were false negative and 18 were true negative. Sensitivity, specificity, negative predictive value and negative predictive value were 74.68% 26.87%, 78.02% and 23.37% respectively. Conclusion: Alvarado scoring system is useful tool in diagnosis of appendicitis in pre-operative period which can be useful for surgeons at any level of health care. According to our study observations Alvarado scoring system has better sensitivity 74.68% but specificity 26.87% which shows that Alvarado scoring system is helpful in diagnosis of appendicitis but not much helpful in preventing negative laparotomies. Keywords: Right lower quadrant pain, Appendicitis scoring, Faecal peritonitis, Ultrasound abdomen, Perforated appendix. DOI : 10.7176/JMPB/55-15 Publication date :May 31 st 2019
Highlights
Abdominal pain in right lower quadrant is most common presentation in surgical department and mostly diagnosed as acute appendicitis 1
Pain in lower abdominal quadrant, fever, presence of leukocytosis and diffused peritonitis are the symptoms of acute appendicitis[4]
In our study we evaluate the diagnostic accuracy and implementation performance of Alvarado score
Summary
Abdominal pain in right lower quadrant is most common presentation in surgical department and mostly diagnosed as acute appendicitis 1. Appendicitis remains the most common surgical emergency which needs urgent referral and appendectomy before perforation (worse condition of appendicitis) 2. First case of appendectomy was performed by an English army surgeon in 1935. He removes perforated appendix without any anesthesia. Pain in lower abdominal quadrant, fever, presence of leukocytosis and diffused peritonitis are the symptoms of acute appendicitis[4]. After complete observation if diagnosis is unclear and patient was discharged from hospital he should be advised for follow up within 24 hours or in case of symptoms reoccur[6]. There is noany contraindication of appendectomy if symptoms are present
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
