Modified Alvarado scoring system as a diagnostic tool for acute appendicitis at a tertiary care teaching hospital, Central India: a cross sectional study
DOI:
https://doi.org/10.18203/2349-2902.isj20173142Keywords:
Acute appendicitis, Alvarado scoring, Modified Alvarado scoring system, HistopathologyAbstract
Background: Acute Appendicitis forms an important emergency in the day-to-day surgical practice. It affects human beings irrespective of age, nationality and religion. Early diagnosis and prompt operative intervention is the key for successful management of acute appendicitis. However, the picture of acute appendicitis may not be classical, and in such situations, a policy of early intervention to avoid perforation may lead to high negative appendicectomy rates.
Methods: A total of 80 patients were enrolled in the present cross sectional study. Their ages ranged from eleven to 72 years (mean 32.89 ± 15.87). A proforma containing general information about the patient plus eight variables based on the modified Alvarado scoring system was filled.
Results: Histological examination confirmed appendicitis in 54 patients (67.5%). The remaining 26 patients were found to have normal appendix giving a negative appendicectomy rate of 32.5% being 36.8% and 28.3% for males and females respectively.
Conclusions: This scoring system is easy, simple and cheap complementary aid for supporting the diagnosis of acute appendicitis. MASS can be used effectively in Indian setup to reduce the incidence of negative appendectomies. The patients are not unduly exposed to risks of delay in intervention or significant increase in number of false negative cases.
Metrics
References
Stephens PL, Mazzucco JJ. Comparison of ultrasound and the Alvarado score for the diagnosis of acute appendicitis. Conn Med. 1999;63:137-40.
Cuschieri A. The small intestine and vermiform appendix. In Essential surgical practice. 3 edition. Edited by: Cuscheri A, Giles GR, Mossa AR. London: Butter worth Heinman; 1995:1325-8.
Kanumba ES, Mabula JB, Rambau P, Chalya PL. Modified Alvarado scoring system as a diagnostic tool for acute appendicitis at Bugando Medical Centre, Mwanza, Tanzania. BMC Surg. 2011;11:4.
Craig S, Inceu L, Taylor C. Appendicitis. Medscape. 2014;17:773895.
Partrick DA, Janik JE, Janik JS, Bensard DD, Karrer FM. Increased CT scan utilization does not improve the diagnostic accuracy of appendicitis in children. J Pediatr Surg. 2003;38:659-62.
Buckius MT, McGrath B, Monk J, Grim R, Bell T, Ahuja V. Changing epidemiology of acute appendicitis in the United States: Study period 1993-2008. J Surg Res. 2012;175:185-90.
Bundy DG, Byerley JS, Liles EA, Perrin EM, Katznelson J, Rice HE. Does this child have appendicitis? JAMA. 2007;298:438-51.
Reilly BM, Evans AT. Translating clinical research into clinical practice: impact of using prediction rules to make decisions. Ann Intern Med. 2006;144:201-9.
Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986;15:557-64.
Howell JM, Eddy OL, Lukens TW, Thiessen ME, Weingart SD, Decker WW. Clinical policy: critical issues in the evaluation and management of emergency department patients with suspected appendicitis. Ann Emerg Med. 2010;55:71-116.
Ohle R, O’Reilly F, O’Brien KK, Fahey T, Dimitrov BD. The Alvarado score for predicting acute appendicitis: a systematic review. BMC Med. 2011;9:139.
Kalan M, Talbot D, Cunliffe WJ, Rich AJ. Evaluation of the modified Alvarado score in the diagnosis of acute appendicitis: a prospective study. Ann R Coll Surg. 1994;76:418-9.
Ohmann C, Yang Q, Franke C. Diagnostic scores for acute appendicitis. Eur J Surg. 1995;161:273-81.
Fenyo G, Lindberg G, Blind P, Enochsson L, Oberg A. Diagnostic decision support in suspected acute appendicitis: validation of a simplified scoring system. Eur J Surg Med. 1997;163:831-8.
Jawaid A, Asad A, Motiei A. Clinical scoring system: a valuable tool for decision making in cases of acute appendicitis. J Pak Med Assoc. 1999;49(10):254-9.
Baidya N, Rodrigues G, Rao A. Evaluation of Alvarado score in acute appendicitis: a prospective study. Internet J Surg. 2007;9(1). Available at http://ispub.com/IJS/9/1/10672. Accessed on 10 February 2017.
Dey S, Mohanta PK, Baruah AK, Kharga B, Bhutia KL, Singh VK. Alvarado scoring in acute appendicitis: a clinicopathological correlation. Ind J Surg. 2010;72(4):290-3.
Khan I, Rehman A. Application of alvarado scoring system in diagnosis of acute appendicitis. J Ayub Med Coll Abbottabad. 2005;17(3):414.
Said HS, Chavda SK. Use of modified Alvarado score in the diagnosis of acute appendicitis. East African Med J. 2003;80:411-4.
Edino ST, Mohammed AZ, Ochicha O, Anumah M. Appendicitis in Kano, Nigeria. A 5-year review of pattern, morbidity and mortality. Ann African Med. 2004;3:38-41.
Asefa Z. Pattern of acute abdomen in Yirgalem Hospital, southern Ethiopia. Ethiopian Med J. 2000;38(4):227-35.
Blisard D. Institutioning a clinical guideline to decrease the rate of negative appendicectomy. Am Surg. 2003;69:796-8.
Adesunkanmi ARK, Agbakwuru EA, Adekunle KA. Pattern and outcome of acute appendicitis in semi-urban and rural African communities: a study of 125 patients. Nigerian Med Pract. 1998;36:8-11.
Daelalin L. Acute appendicitis during the first three years of life. Acta Chir Scan. 1982;148:291.
Horatas MC, Guyton DP, Wu D. A reappraisal of appendicitis in the elderly. Am J Surg. 1990;160(3):291-3.
Chan MY, Teo BS, Ng BL. The Alvarado score and acute appendicitis. Ann Acad Med Singapore. 2001;30(5):510-2.
Gilmore OJA, Jones D, Ynag Q. Appendicitis and mimicking conditions. Lancet. 1975;II:421-4.
Flum DR, Morris A, Koespell T, Delinger EP. Has misdiagnosis of appendicitis decreased overtime? A population based analysis. JAMA. 2001;286:1748.
Jeerapata. The modified Alvarado score versus Alvarado score for the diagnosis of acute appendicitis. THAI J Surg. 2005;26:69-72.
Sanjot B. One-year prospective study to compare and evaluate diagnostic accuracy of modified Alvarado score and ultrasonography in acute appendicitis in adults. Indian J Surg. 2008;70:125-9.
Shrivastava UK, Gupta A, Sharma D. Evaluation of the Alvarado score in the diagnosis of acute appendicitis. Trop Gastroenterol. 2004;25:184-6.
Sadiq M, Amir S. Efficacy of modified Alvarado scoring system in the diagnosis of acute appendicitis. J Postgrad Med Inst. 2002;16:72-7.
Menon ZA, Irfan S, Fatima K, Iqbal MS, Sami W. Acute appendicitis: Diagnostic accuracy of Alvarado scoring system. Asian J Surg. 2013;36(4):144-9.
Downloads
Published
How to Cite
Issue
Section
