A clinical comparative study of different scoring systems in acute appendicitis


  • Prashant Nema Department of Surgery, PCMS & RC, Bhopal, India
  • Ajay Kumar Jain Department of Surgery, PCMS & RC, Bhopal, India




Appendicitis, Alvarado, Christian, Izbicki, Clinical scoring systems


Background: Diagnosis of appendicitis continues to be an issue in surgeon’s lives. Despite the wide availability diagnostic methods, clinical dilemma persists. An ideal diagnostic tool helps avoid unnecessary surgeries without missing on potential complications.

Methods: Current study evaluates the role of three diagnostic scoring systems in cases of appendicitis.

Results: Out of the 48 cases the mean age for appendicitis was 30.12 (SD 13.27; Range: 10-55 yrs). Males (75%) predominated over females (25%). Pain in right iliac fossa (97%), nausea/ vomiting (94%) and fever (69%) were common presenting symptoms while shift of tenderness to right iliac fossa (90%), guarding (83%) were common clinical signs elicited. Alvarado had lowest Negative Appendicectomy Rate (18.9) and Missed Perforation Rate (nil) while Izbicki had lowest Potential Perforation Rate (14.3) among all.

Conclusions: Although, a spectrum of diagnostic methods is available, careful use of clinical scoring systems may supplement as a tool in taking management decisions. This study shows that the Alvarado score fairly predicts appendicitis by minimizing negative appendicectomies. Patients presenting as emergency in resource limited settings, could benefit from Alvarado score.


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