Alvarado Score In Diagnosis Research Articles

A comparative study of Appendicitis inflammatory response (AIR) score with Alvarado score in diagnosis of acute appendicitis at KCMC Hospital

Background: Acute appendicitis is an acute inflammation of the appendix, most resulted from obstruction of the lumen of the appendix. It is one of the most common causes of acute abdomen. Although a very common and long-known phenomenon, appendicitis remains a diagnostic challenge for most surgeons. Objective: To compare the validity of Appendicitis Inflammatory Response Score with Alvarado score in diagnosis of acute appendicitis at KCMC Hospital. Methods: A prospective hospital based cross sectional study done over a period of six months (September 2016 to March 2017). Patients were admitted to general surgical ward after the diagnosis of acute appendicitis reached and all parameters included in the AIR score and Alvarado score were prospectively recorded on patients presenting symptoms of acute appendicitis. All removed appendix specimens were sent for histopathological examination. Data was entered and analyzed using statistical package of social sciences version 20. Results: A total of 35 patients enrolled in this study, 57% male, male to female ratio 1.3:1, mean age of 27(14-49) years. 31 patients confirmed histologicaly to have features of acute appendicitis, among these inflamed appendicitis were 51.6%. And advanced appendicitis 48.4% and negative appendicectomy rate was 11.4%. The sensitivity and specificity of both AIR and Alvarado score were 54.4%, 77.4% and 75%, 75%. PPV and NPV were 94.4%, 96% and 17.6%, 30% respectively. Conclusion: From our study we have seen Alvarado score is a better assessment tool that is accurate helping in diagnosis of acute appendicitis. Its high sensitivity and ROC is greater than that of the AIR score. We conclude that AS has outperform AIR score in accuracy in diagnosis of AA.

Accuracy and sensitivity of RIPASA score Versus Alvarado score in diagnosis of acute appendicitis.

Accuracy and sensitivity of RIPASA score Versus Alvarado score in diagnosis of acute appendicitis.

A comparative study of RIPASA score and modified Alvarado score in diagnosis of acute appendicitis

A comparative study of RIPASA score and modified Alvarado score in diagnosis of acute appendicitis

COMPARISON OF RIPASA AND ALVARADO SCORING SYSTEM IN DIAGNOSIS OF ACUTE APPENDICITIS IN TERTIARY CARE

Introduction: Acute appendicitis is one of the most common surgical emergencies, with a lifetime prevalence rate of approximately one in seven. Different techniques have been devised to assist in equivocal cases in attempts to decrease negative appendectomy rates. RIPASA and ALVARADO scores are new diagnostic scoring systems for diagnosis of acute appendicitis . RIPASA scoring system has more sensitivity, specificity and diagnostic accuracy than ALVARADO score in diagnosis of acute appendicitis in Asian population. Hence this study conducted to compare RIPASA AND ALVARADO score in diagnosis of acute appendicitis in tertiary care hospital. RIPASA score includes more parameters than ALVARADO score such as age, gender, duration of symptoms prior to presentation Aims and objectives: To compare RIPASA and Alvarado score in diagnosing acute appendicitis using histopathology as gold standard Materials and Methods: Source of Data: Basaveshwar teaching and general hospital from august 1st to 30th september 2022 Study Design: Prospective observational study. Study Population: 74 patients Inclusion criteria All patients who presented with right lower quadrant abdomen pain and diagnosed as acute appendicitis. Exclusion Criteria: Patients under 18 years of age. Patients with right iliac fossa mass. Patients with features of peritonitis All these patients were scored as per RIPASA and Alvarado scoring system after taking history , clinical examination and laboratory investigations. RIPASA includes 18 parameters and Alvarado 8 parameters. A score of 7.5 taken as high probability of acute appendicitis as per RIPASA and score of 7 for Alvarado scoring system. The decision of appendicectomy solely based on surgeonÂ’s own clinical judgement After the surgery, histopathological reports of operated cases correlated with scoring systems.

The Role of Alvarado Score in Diagnosis of Acute Appendicitis in a Tertiary Care Hospital

Background: Acute appendicitis is one of the most common abdominal emergencies encountered in surgical practice. The diagnosis of acute appendicitis is an enigmatic challenge. Several studies have reported a variable diagnostic accuracy with a negative appendectomy rate varying from 3% up to 20% using combined diagnostic modalities or using the Alvarado score alone.

A prospective study for evaluation of Alvarado score in diagnosis of acute appendicitis

Background: Acute appendicitis is a common cause of abdominal pain for which a prompt diagnosis is rewarded by a decrease in morbidity and mortality. Delay in the diagnosis will lead to an increased morbidity and mortality rate, on another hand overzealous diagnosis may lead to increased negative appendectomy rates. Notwithstanding advances in modern radiographic imaging and diagnostic laboratory investigations, the diagnosis of appendicitis remains essentially clinical. To decrease the negative appendectomy rate and to increase the positive diagnostic rate of appendicitis, various scoring systems were designed. Alvarado score is one of them.Methods: A total of 100 operated cases of appendicectomy were studied. Their clinical diagnosis, assessed by the Alvarado scoring is compared with radiological and histopathological diagnoses, to obtain the sensitivity and specificity of the Alvarado score system. NPV, PPV, and percentages of various demographic and clinical data were calculated accordingly.Results: In this study, the positive predictive value of Alvarado scoring is found to be high i.e.; patients will have a high chance of acute appendicitis. On the other hand, the negative predictive value is low. Sensitivity for Alvarado's score is 50% while specificity is 88.9%.Conclusions: In this study, we concluded that the Alvarado score has a very high positive predictive value i.e.; diagnostic accuracy. Also with the help of the Alvarado score, we can reduce the number of negative appendicectomies.

Comparison of Diagnostic Accuracy of Appendicitis Inflammatory Response Score and Alvarado Score in Diagnosis of Acute Appendicitis Taking Histopathology as Gold Standard

Objective: To compare the diagnostic accuracy of appendicitis inflammatory response score and Alvarado score in diagnosis of acute appendicitis taking histopathology as gold standard. Study Design: It is a Cross Sectional Study Study setting and Duration: This study conducted at the Department of General Surgery, Abbasi Shaheed Hospital, Karachi from September 2018 To March 2019. Methods: Alvarado and Appendicitis inflammatory response scores were used to evaluate all patients. For the Alvarado scoring system, a score of 7 or more was considered a high chance of acute appendicitis, while the AIR scoring system required a score of 9 or higher. The findings of the histopathology lab were compared to the test results. Both tests' results were analysed to determine their sensitivity, specificity, and diagnostic accuracy. Results: For Alvarado score Sensitivity (80.1%), Specificity (92.3%) and accuracy was 81.7%. For AIR score Sensitivity (72.6%), Specificity (94.2%), and accuracy was 75.5%. There were 66.9% male and 33.1% female patients. Right iliac fossa pain was 76.8%, pain migration to right iliac fossa was 63.5%, anorexia was 90.9%. Conclusion: Higher sensitivity and specificity of the Appendicitis inflammatory response score and the Alvarado score were found to outperform the histological findings in appendicitis. Keywords: Appendicitis, Appendicitis Inflammatory Response Score, Diagnostic Accuracy, Acute Appendicitis, Histopathology, Alvarado Score,

Diagnostic Accuracy of Alvarado Score in Diagnosis of Acute Appendicitis in Patients with Acute Pain Right Iliac Fossa

Background: The gold standard treatment of acute appendicitis is appendectomy. Early surgery reduces a number of complications such as appendicular mass formation, abscess and perforation. However, diagnostic inaccuracy especially in female gender can lead to negative appendectomy because other gynecological diseases have quite similar presentation. The objective of our study is to determine the diagnostic accuracy of Alvarado scoring system in the diagnosis of acute appendicitis in comparison to the gold standard histopathology in patients with acute pain right iliac fossa. Methods: This descriptive Cross-sectional study was carried out on 253 patients with acute pain in right iliac fossa at Surgical Department of MTI, Lady Reading Hospital from 14th July 2020 to 14th January 2021. Results: Mean age was 37 years with standard deviation ± 10.09. 111(44%) patients were male and 142(56%) patients were female. 129(51%) patients were married while 124(49%) patients were unmarried. Based on Alvarado scoring Acute appendicitis was diagnosed in 197(78%) patients and missed in 56(22%) patients. Diagnosis of Acute appendicitis was confirmed by histopathology report in 245(97%) patients while in 8 (3%) patients histopathology did not reveal acute infection. Diagnostic accuracy of Alvarado scoring analyzed with histopathological diagnosis was 78.65%. Conclusion: Alvarado scoring has a sensitivity of 79.18%, specificity 62.5%, PPV 98.47%, NPV 8.92% and diagnostic accuracy of 78.65% in diagnosis of acute appendicitis taking histopathology as gold standard in patients with acute pain right iliac fossa. Keywords: Acute Appendicitis, Alvarado, Histopathology, Diagnostic accuracy

Evaluation of the Appendicitis Inflammatory Response Score against Alvarado Score in Diagnosis of Acute Appendicitis

Background Patients presenting with suspected appendicitis pose a diagnostic challenge. Various scoring systems have been designed to aid in the clinical assessment of these patients. Widely applied was Alvarado score and best performed in validating studies, but was observed with few drawbacks. Appendicitis inflammatory response (AIR) score was designed to overcome the drawbacks associated with the implementation of Alvarado scoring system. Objective The main objective of this study was to evaluate the Appendicitis inflammatory Response Score and compare its performance in predicting risk of appendicitis with the Alvarado score. Method Appendicitis inflammatory response score and Alvarado scores were calculated prospectively on patients suspected of acute appendicitis presenting to Manipal Teaching Hospital, Pokhara, Nepal between July 2017 and June 2019. Diagnostic performance of the two scores was compared. Statistical analysis was done using SPSS 21 and p value < 0.05 was considered significant. Result The study included 217 patients with 109 (50.2%) males and 108 (49.8%) females. The mean age of patients was 25.77±15.54. The results analyzed showed better sensitivity of Appendicitis Inflammatory Response score (96.91%) as compared to 94.30% of Alvarado score. The positive and negative predictive values of Alvarado score were 74.87% and 50%, as compared to 79.70% and 72.20% for AIR score. Furthermore, the area under receiver operating curve of the appendix inflammatory response score was better (0.701) than that of Alvarado score (0.580). Conclusion Appendicitis Inflammatory Response (AIR) scoring performed well and more accurate than Alvarado scoring system with high specificity and high negative predictive value preventing negative appendectomies.

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

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.

Evaluation of the significance of Alvarado score in the diagnosis of acute appendicitis in tribal area

Background: Acute Appendicitis is a common surgical emergency which even with modern diagnostic facilities remains a challenging task for the surgeon. The variation in the presentation can confuse even experienced surgeons. On looking at the literature, it was found that a negative Appendicectomy rate has been consistently mentioned Aim- The following study was therefore conducted for Evaluation Of Significance Of Alvarado Score In Diagnosis Of Acute Appendicitis In Tribal Area. This is an old standard scoring system, very economical, noninvasive, and revalidation was done in the tribal area to reach the diagnosis. Material and Methods: A Study of 180 patients of acute appendicitis was conducted in tribal areas and Alvarado score carries high significant value in diagnosis and management of acute appendicitis. The period to study was from August 2018 to January 2020. Result: 180 patients were subjected to Appendicectomy. Out of the 33 were operated by laparoscopy (18.33%). All the Appendicectomy specimens were studies macroscopically and microscopically. All the specimens were cut open and inspected for pathology. Conclusion: The present study concludes that the Alvarado score, an economical, noninvasive clinical scoring system, carries high significant value in the diagnosis and management of acute appendicitis in the tribal area.

Role of alvarado score in diagnosis of acute appendicitis

Background: Appendicitis may be associated with morbidity and occasionally mortality. If failed to diagnose early, the situation may become more complicated.&#x0D; Objective: To validate the role of Alvarado score in diagnosis of acute appendicitis.&#x0D; Methods: A total of 282 patients with clinically diagnosed acute appendicitis were included in this study. Patients were examined thoroughly, investigated and managed accordingly. The relevant data collected and analyzed. Results: Out of 282 patients, surgical procedures were performed in 59.57% of the patients. The overall negative Appendectomy rate was 9.52%, and the percentage of Positive Predictive Value (PPV) for Alvarado score was 92.26%.&#x0D; Conclusion: Our study validates the Alvarado score as fast, simple and reliable diagnostic tool for acute appendicitis.&#x0D; Journal of Surgical Sciences (2017) Vol. 21 (2): 94-98

A comparative study of RIPASA score and modified Alvarado score in diagnosis of acute appendicitis

Background: Various diagnostic criteria have been described for diagnosing acute appendicitis. Of these, Alvarado score has been the most commonly used. The RIPASA score is a new diagnostic scoring system developed for the diagnosis of acute appendicitis and showed higher sensitivity, specificity and diagnostic accuracy as compared to Alvarado score. we want to compare prospectively Alvarado and RIPASA score by applying them to patients attending emergency department complaining of right iliac fossa pain that could probably be acute appendicitis.Methods: Patients with clinically suspected acute appendicitis were classified according to both Alvarado and RIPASA scoring systems before undergoing surgery. Histopathological examination of the removed appendix was taken as the gold standard for diagnosis of acute appendicitis.Results: Among (90%) patients had histologically confirmed appendicitis. With the cut-off value greater than 7.5 for RIPASA score; sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy were 88.2%, 14.5%, 73.1%, 32%,and 68% respectively. With the cut-off value greater than 7 for Alvarado score, sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and negative appendectomy rates were 51.2%, 80 %, 91 %, 29%, and 57%, respectively. 87.5% of patients were correctly stratified by RIPASA under higher probability group while only 45% were classified by Alvarado as high probability.Conclusions: RIPASA scoring system showed high sensitivity and diagnostic accuracy in comparison to Alvarado scoring system. So, it can be applied for the diagnosis of acute appendicitis.

Use of Modified Alvarado Score in Diagnosis of Acute Appendicitis: A Prospective Study

Use of Modified Alvarado Score in Diagnosis of Acute Appendicitis: A Prospective Study

Comparative Study between Ultrasonography &amp; the Alvarado Score in Diagnosis of Acute Appendicitis - A Study of 110 Cases

Comparative Study between Ultrasonography &amp; the Alvarado Score in Diagnosis of Acute Appendicitis - A Study of 110 Cases

A comparative study of RIPASA score and ALVARADO score in diagnosis of acute appendicitis

Background: The RIPASA Score is a new diagnostic scoring system developed for the diagnosis of Acute Appendicitis which showed higher sensitivity, specificity and diagnostic accuracy compared to ALVARADO Score, particularly when applied to Asian population. Not many studies have been conducted to compare RIPASA and ALVARADO scoring systems. Hence, author want to compare prospectively Alvarado and RIPASA score by applying them to the patients attending the hospital with right iliac fossa pain that could probably be acute appendicitis.Methods: A prospective analysis of 116 cases admitted with RIF pain during a 2 years period was performed. Patients between 15-60 years were scored as per Alvarado and RIPASA scoring system. Histopathological reports of the cases were collected and compared with the scores. ROC curve area analysis was performed to examine diagnostic accuracy of RIPASA and ALVARADO scores.Results: The sensitivity of ALVARADO score is estimated to be 52.08 for a cut off of 6. The specificity is 80%, positive predictive value is 92.59, negative predictive value is 25.81. The Diagnostic accuracy of ALVARADO scoring is found to be 56.9. The sensitivity, specificity, positive predictive value and negative predictive values of RIPASA scoring system are 75%, 65%, 91.14%, 35.14%. The diagnostic accuracy of RIPASA score is 73.28.Conclusions: The difference in the diagnostic accuracy between ALVARADO and RIPASA scoring system is significant indicating that the RIPASA score is a much better diagnostic tool for the diagnosis of acute appendicitis. When the ROC curve was observed the area under the curve is high for RIPASA scoring system.

AB204. 171. Construction of a novel clinico-biochemical score outperforms Alvarado score in diagnosis of appendicitis

Background: Diagnosis of acute appendicitis (AA) remains challenging. We have previously shown that circulating fibrocytes (CFs) are elevated in AA. This study aimed to construct a novel clinico-biochemical scoring system and compare its diagnostic accuracy to Alvarado score in diagnosing acute appendicitis.

Comparison of acute inflammatory score and Alvarado score in diagnosis of acute appendicitis at a tertiary care hospital

Background: Acute appendicitis remains as one of the most common surgical entity requiring early intervention. Hence there is always a need to develop a well-designed protocol for diagnosis and to reduce negative appendectomy. The most common and widely applied was Alvarado score and best performed in validating studies, but was observed with few drawbacks. A recently introduced appendicitis inflammatory response score (AIR) was designed to overcome the drawbacks associated with the implementation of Alvarado scoring system. The objective the present study was to evaluate the AIR score on cases of suspicious appendicitis and to compare it with Alvarado scorings system.Methods: A prospective study for a period of two years from March 2015 to February 2017 was conducted on consecutive patients who presented to emergency department and scoring was performed based on the necessary variables.Results: The present study was conducted on 300 cases suspicious of appendicitis. The results analysed showed the area under the ROC curve of the AIR score was 0.94 and better than the area under the curve of Alvarado score of 0.82. The AIR score also did well in difficult cases of women, children when compared to Alvarado score in diagnosis of appendicitis. In our study, in cases with &gt;8 points, a lower sensitivity was observed in AIR scoring than Alvarado scoring (0.26 vs. 0.12), but was associated with higher specificity (1.00 vs. 0.95). In these cases, PPV turned out to be 1.00 for AIR scoring and 0.77 for Alvarado scoring.Conclusions: To conclude, AIR scoring performed well almost equally with Alvarado system with high specificity and high negative predictive value preventing unnecessary negative appendectomies. Follow up of these cases will help in deciding surgical intervention in unnecessary cases. This scoring system also prevents unnecessary and costly radiological investigations thereby reducing the financial burden to the patients.

Evaluation of Role of Alvarado Score in Diagnosis of Acute Appendicitis: A Prospective Study

Evaluation of Role of Alvarado Score in Diagnosis of Acute Appendicitis: A Prospective Study

Correlation of Alvarado score for acute appendicitis with pathological acute appendicitis

Background: The vermiform appendix is important in surgery due to its propensity for inflammation which results in the clinical syndrome known as acute appendicitis. Approximately 7% of the population will have appendicitis in their life time, with the peak incidence occurring between 10 and 30 years. There occur numerous instances in the practice of medicine which demand of the physician expert diagnostic skill, sound judgment, quick and competent treatment. In 1986, Alvarado evaluated common clinical and laboratory findings in relation to pathologically proven acute appendicitis. Alvarado score had sensitivity of 81% and a specificity of 74%. The main objective is to study efficacy of Alvarado score in diagnosis of acute appendicitis Methods: This is a randomized study comprising of 138 patients of suspected acute appendicitis. The patients with suspected acute appendicitis are evaluated on the basis of the Alvarado scoring system on admission and divided into 3 groups (A, B and C). Patients were treated based on the clinical impression, following all standard surgical principals. The surgical specimen was sent for histopathological examination for confirmation of diagnosis. Data was collected, recorded and then processed. Results: Out of total 138 patients included in study, 117 patients were subjected to emergency appendectomy. 111 patients out of 117 patients operated were true positive for acute appendicitis, confirmed by histopathology report. Rest 6 patients out of 117 had normal appendix on histopathology. The Sensitivity of Alvarado score was 92.79%, specificity was 77.77%, positive predictive value was 94.49% and negative predictive value was 72.14% in our study. Conclusions: Alvarado scoring system is a good diagnostic indicator for acute appendicitis. It helps in reducing the number of negative appendicectomies.