Analysis of application and diagnostic importance of Alvarado scoring system in patients with right lower quadrant abdominal pain

Abstract

Background: Acute Appendicitis is a common emergency condition requiring surgical intervention. Accurate diagnosis is the deciding factor in reducing the morbidity and mortality associated with the illness and is also the key to avoid unnecessary appendectomies. In this study we analyse the clinical efficacy of modified Alvarado scoring in diagnosing acute appendicitis

Methods: In a prospective non-randomized study including 99 patients presenting with acute onset right lower abdominal pain  from to were included in study in whom the alvarado score was obtained at admission and categorized into three groups and group 3 and group 2 patients with deterioration underwent emergency appendicectomy compared with histo-pathological diagnosis. Sensitivity, specificity, positive predictive value, negative predictive value and negative appendicectomy rate calculated.

Results: In our study, overall sensitivity and specificity were 98.50% and 87.09% respectively. Positive and negative predictive values were 94.36% and 96.42 respectively. Overall Negative appendicectomy rate in our study was 5.9%.

Conclusions: We conclude that Alvarado scoring system is easy, simple, cheap and useful tool in pre-operative diagnosis of acute appendicitis which can be used in the community by general practitioner and residents in the referral hospitals. Scores more than seven virtually confirm the diagnosis of acute appendicitis and early operation is indicated.