Alvarado Scoring System in Prediction of Acute Appendicitis

作者：Jalil Ana^*; Shah Syed Aslam; Saaiq Muhammad; Zubair Muhammad; Riaz Umbreen; Habib Yasir

来源：Journal of the College of Physicians and Surgeons Pakistan, 2011, 21(12): 753-755.

• Acute appendicitis
• Alvarado score
• Appendicectomy
• Appendectomy

Objective: To evaluate the diagnostic accuracy of Alvarado score for the prediction of acute appendicitis.
Study Design: Analytical study.
Place and Duration of Study: This study was carried out in the Department of Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, during the period from January 15, 2009 to July 15, 2010.
Methodology: The study included all adult patients of either gender who presented with clinical findings suggestive of acute appendicitis, who were assigned Alvarado score of < 4 pre-operatively and subsequently underwent emergency appendicectomy with histological examination of the resected specimens. Based on the Alvarado score, the patients were stratified into two groups. i.e. Group I (with a score of > 7) and Group II (with a score of 5-7). Alvarado score was compared with the histopathology. The data was subjected to statistical analysis to measure the objective.
Results: The overall sensitivity, specificity, positive predictive value and negative predictive value of Alvarado score for acute appendicitis were 66%, 81%, 96%, 29% respectively. The sensitivity was higher though not significant, for males with a score over 7 than females with similar scores (97% vs. 92%). However, for scores less than 7, sensitivity among males was significantly higher than females with similar scores (79% vs. 61%; p < 0.05).
Conclusion: The presence of a high Alvarado score in adult males is highly predictive of acute appendicitis, however, in women of child bearing age other causes of similar clinical presentation lead to a low diagnostic accuracy of the score.

• 出版日期2011-12
• 单位河北医科大学