Alvarado Score In Diagnosis Research Articles

The Validity of Alvarado Score in Diagnosis of Acute Appendicitis among Sudanese Patients

Background Acute appendicitis is the most common cause of an acute abdomen in young adult with a life time risk of about 6% and appendectomy is the most frequently performed urgent abdominal operation. Diagnosis of acute appendicitis is clinical, the most widely used clinical scoring system is the Alvarado score also known by the acronym mantrels. A decision to operate depending on clinical suspicion only lead to removal of a normal appendix in 15- 30 % of cases Objectives To Measure the diagnostic accuracy of Alvarado score as rule in score at cut point of 7 and Assessment of the rule of application of the score in reduction of negative appendectomy. Methods This study is designed as descriptive cross sectional and includes 84 patients whom are admitted as a case of acute appendicitis by surgical emergency unit, Alvarado score was calculated for each patient. Data is analysed using SPSS. Results Negative appendectomy was found in 7.1% of patients, all were Alvarado score below 7. 37% of overall patients had complicated appendix. At cut point 3 of the score no inflamed appendix was found and at cut of point 7 no normal appendix was found. Elevated temperature was found negative in 43.6% of positively inflamed appendix. Conclusion and recommendations At cut point of 7 Diagnostic accuracy of Alvarado score is 100% (all patients at or above 7 have positive surgical appendicitis). 43% of those with positive appendicitis have no fever. Health education is required to improve and ensure early detection of appendicitis and decrease the high percentage of complicated appendix. Application of Alvarado score may decrease negative appendectomy. Alvarado score require revision and modification to include only high sensitive and specific clinical symptoms and signs and also it includes left shift of Neutrophil maturation, which is not routinely done in many laboratories.

Usefulness of Modified Alvarado Score in Diagnosis of Acute Appendicitis in Adults

Background: Definitive diagnosis of acute appendicitis preoperatively is sometimes difficult. Failure to make a diagnosis is the main reason for persistent rate of morbidity and mortality. Various scoring systems are devised to aid diagnosis of acute appendicitis. In some studies the modified Alvarado score was helpful, reliable and practical in minimizing unnecessary appendectomy. Objective: The purpose of this study was to evaluate the usefulness of modified Alvarado score for the diagnosis of acute appendicitis. Materials and Method: A prospective study of 89 adult patients, admitted with abdominal pain suggestive of acute appendicitis, from July 2011 to June 2012, was conducted. Data including clinical signs and symptoms and laboratory findings were recorded in modified Alvarado score record form. All 89 patients underwent appendectomy. Final diagnosis was confirmed by histopathological examination. Reliability of scoring system was assessed by negative appendectomy rate and positive predictive value. Results: Out of 89 patients who underwent appendectomy, 85 had acute appendicitis on histopathology. Positive predictive value was 95.5% and negative appendectomy rate was 4.5%. 52.8% had score 7 or above and 47.2% had score less than 7. From score it is difficult to predict which patient warranted appendectomy and who may be safely observed or discharged. Conclusions: Diagnosis of acute appendicitis remains mainly clinical evaluation and it is more helpful than modified Alvarado scoring system in adults.Bangladesh Journal of Medical Science Vol.14(4) 2015 p.336-338

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

Context: To compare Appendicitis inflammatory response score (AIR) and Alvarado score in diagnosis of acute Appendicitis. Methods and methods: All parameters included in the AIR score and Alvarado score were prospectively recorded on patients presenting symptoms of acute appendicitis from June 2013 to November 2015 in SMHS Govt. Medical college Srinagar. The diagnostic performance of two scoring systems was compared. Results: The present study included 108 patients tentatively diagnosed with acute appendicitis. Only 8 patients had undergone negative appendectomy. AIR score was more sensitive in excluding patients with negative appendicitis. Hence the study included only 100 patients out of which 60 were males and 40 females. The area under Roc curve was 0.87 for males in AIR score and 0.64 in Alvarado score. In case of females, the area was 0.89 in Air score and 0.69 in Alvarado score. The AIR score performed very well in both males and females (p

Tzanakis Score vs Alvarado in Acute Appendicitis

INTRODUCTION: 
 Acute appendicitis is a common surgical emergency. Accurate diagnosis and timely intervention reduces mortality and morbidity. This study compared the efficacy of Tzanakis and Alvarado score in diagnosis of acute appendicitis.
 METHODS:
 A prospective, non randomized study was conducted in 100 consecutive patients who had undergone emergency appendectomy from May 2008 to October 2008. Tzanakis and Alvarado scores were obtained at the time of admission. Final diagnosis of acute appendicitis was based on histological findings.
 RESULTS:
 The sensitivity, specificity and overall diagnostic accuracy of Tzanakis score was 91.48% and 66.66% and 90% respectively. The sensitivity, specificity and overall diagnostic accuracy of Alvarado score was 81.91% and 66.66% and 81% respectively. Negative appendectomy rate was 6%.
 CONCLUSIONS:
 Tzanakis score is an effective modality to establish the accurate diagnosis of acute appendicitis.
 Keywords: acute appendicities, Tzanakis score, Alvarado Score.