APPLICATION OF ALVARADO SCORING SYSTEM IN DIAGNOSIS OF ACUTE APPENDICITIS

Authors

  • Ikramullah Khan
  • Ata ur Rehman

Abstract

Background: In conditions like acute appendicitis it is impractical to have definitive diagnosis bygold standard test (histopathology) before surgery, we would like a simple test like Alvaradoscoring system which depends on the presence and absence of certain variables and whichprovides an accurate guide to whether or not the patient has the condition. This study wasconducted to evaluate Alvarado scoring system for the diagnosis of acute appendicitis in our setup. Methods: 100 consecutive patients with suspected acute appendicitis admitted in Surgical Bunit, Khyber Teaching Hospital Peshawar, during the period from July to December 2003 wereincluded in the study. They were given specific scores according to the variables of Alvaradoscoring system and then divided into 3 groups. Group 1 patients (score 7 or more) underwentsurgery, group 2 patients (score 5-6) were admitted for observation and group 3 patients (score 4or less) were discharged home. Patients from group 2 with increased symptom intensity (score 7or more) in reevaluation underwent surgery. Diagnosis was confirmed by histopathologicalexamination. Reliability of scoring system was assessed by calculating negative appendicectomyrate and positive predictive value. Results: Out of a total 100 patients 64 patients underwentsurgery and appendicitis was confirmed in 54 cases, thus giving negative appendicectomyfrequency of 15.6% (male 12%, female 17.9%). Perforation rate was 7.8%. Positive predictivevalue was 84.3% (males 88%, females 82.1%). Conclusion: This scoring system is easy, simpleand cheap complementary aid for supporting the diagnosis of acute appendicitis especially forjunior surgeons.Key words: Acute appendicitis, Appendicectomy, Scoring system.

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