A three year prospective study-suspected acute appendicitis:                 diagnostic accuracy of modified Alvarado score versus ultrasonography in adults

Murhari D. Gaikwad; Anand Auti; Avinash Magare

doi:10.18203/2349-2902.isj20175145

Authors

Murhari D. Gaikwad Department of Surgery, IIMS and R Medical College, Warudi, Jalna, Maharashtra, India
Anand Auti Department of Surgery, IIMS and R Medical College, Warudi, Jalna, Maharashtra, India
Avinash Magare Department of PSM, IIMS and R Medical College, Warudi, Jalna, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20175145

Keywords:

Alvarado score, Appendectomy, Ultrasonography

Abstract

Background: To evaluate and compare diagnostic accuracy of modified Alvarado score and ultrasonography in co-relation to histopathology report for diagnosis of acute appendicitis.

Methods: A prospective study of the patients who underwent appendectomy for suspected acute appendicitis at IIMS and R Medical College and Noor Hospital Warudi, Badnapur, Dist. Jalna (Maharashtra). The clinical (radiological) and ultrasonography data of 760 patients with suspected appendicitis was collected between March 2014 to Feb. 2017. These patients were evaluated by modified Alvarado score and ultrasonographically, which was corrected with histopathological finding.

Results: Out of 760 patients 69.34% had acute appendicitis 63.81% had modified Alvarado score≥7 and 58.28% patients were ultrasonographically positive. In present study modified Alvarado score has sensitivity of 89.37% specificity 93.99% positive predictive value 97.11%, negative predictive value 79.64%, diagnostic accuracy of 81.32%.

Conclusions: Modified Alvarado score can be used effectively in clinical decision making. When compare with ultrasonography neither one is advantageous. However, additional information provided by ultrasonography improves diagnostic accuracy.

Metrics

Metrics Loading ...

References

Sharma R, Kasliwal DK, Sharma RG. Evaluation of negative appendicectomy rate in cases of suspected acute appendicitis and to study the usefulness of ultrasonography in improving the diagnostic accuracy. Indian J Surg. 2007;69(5):194-7.

Kurane SB, Sangolli MS, Gogate AS. A 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(3):125-9.

Hlibezuk V, Dattarao JA, Jin Z, Falzon L, Brown MD. Diagnostic accuracy of non-contrast computed Tomography for appendicitis in adults. Ann Emerge Med. 2010:55:51-9.

Khan I, Rahaman AU. Application of Alvarado scoring system in diagnosis of acute appendicitis. J. Ayub Medical College, Abotabad. 2005;17:41-4.

Rao PM, Rhea JT, Novelline RA, Mostafavi AA, McCabe CJ. Effect of computed tomography of the appendix on treatment of patients and use of hospital resources. New England J Med. 1998;338(3):141-6.

Mardan MA1, Mufti TS, Khattak IU, Chilkunda N, Alshayeb AA, Mohammad AM, et al. Role of ultrasound in acute appendicitis, J. Ayub Medical College Abotabad. 2007;19:72-8.

Petroianu A. Diagnosis of acute appendicitis, International J Surg. 2012;10(2012):115-9.

Kalen M, Rich AJ, Talbot DR, Canlitie WJ. Evaluation of modified Alvarado score in the diagnosis of acute appendicitis a prospective study, Ann R Coll Surg Engl. 1994;76:418-9.

Shaha SWA, Khan CA, Malik SA, Waqas A, Tarrar AM, Bhutta IA. Modified Alvarado score: Accuracy in diagnosis of acute appendicitis in adults. Prof Med J. 2010;17:546-50.

Memon ZA, Irfan S, Fatima K, Iqbal MS, Sami W. Acute appendicitis diagnostic accuracy of Alvarado scoring system, Asian J Surg. 2013;36:144-9.

D’souza N, D’souza C, Grant D, Royston E, Farouk M. The value of ultrasonography in the diagnosis of appendicitis, Int J Surg. 2015;13(2015):165-9.