Evaluation of Alvarado scoring system (MANTRELS scoring) as a diagnostic aid in preoperative diagnosis of acute appendicitis at Nalanda Medical College and Hospital, Patna

Raj Shekhar; V. K. Gupta

doi:10.18203/2349-2902.isj20202817

Authors

Raj Shekhar Department of General Surgery, Nalanda Medical College and Hospital, Patna, Bihar, India
V. K. Gupta Department of General Surgery, Nalanda Medical College and Hospital, Patna, Bihar, India

DOI:

https://doi.org/10.18203/2349-2902.isj20202817

Keywords:

Acute appendicitis, Alvarado score, Sensitivity

Abstract

Background: Acute appendicitis is one of the commonest surgical emergencies. The rate of negative appendicectomy has been reported to be between 20-30%. The aim of this study is to evaluate the efficacy of Alvarado scoring system in cutting down the rate of negative appendicectomy without increasing morbidity and mortality.

Methods: A study of 100 patients presenting with pain abdomen and diagnosed provisionally as acute appendicitis, was undertaken. Depending on individual presentation, a score was calculated for each case, based on Alvarado scoring system. Operative and conservative intervention was undertaken in patients with scores between 5 and 10 and <5 respectively. The results of Alvarado scoring system, on table operative findings and HPE, were reviewed.

Results: A total of 94 patients with score of 7-10 and 5-6 were operated. Among males with score of 7-10, 33 patients were operated and 31 were found to have inflamed appendix. Among females with score of 7-10, 33 patients were operated and 28 were found to have inflamed appendix. The sensitivity of Alvarado scoring system in males with score of 7-10 was found to be 81.57% and among females with score of 7-10 was found to be 75.67%.

Conclusions: The Alvarado scoring system is a fast, simple, reliable, non-invasive, repeatable and safe diagnostic modality without extra expense and complications.

Metrics

Metrics Loading ...

References

Wakeley CP. The position of the vermiform appendix as ascertained by an analysis of 10,000 cases. J Anat. 1933;67:277-83.

Hoffmann J, Rasmussen O. Aids in the diagnosis of acute appendicitis. Br J Surg. 1989;76:774-9.

Ohmann C, Yang Q, Franke C. The abdominal pain study group. 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. 1997;163;831-8.

Scott GB. The primate caecum and appendix vermiform is a comparative study. J Anat. 1980;131:549-63.

Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986;15:557-5.

Teicher I. Scoring system to aid in diagnoses of appendicitis. Ann Surg. 1983;198:753.

Lamparelli M. A prospective evaluation of the combined use of the modified Alvarado score with selective laparoscopy in adult females in the management of suspected appendicitis. Ann R Coll Surg Engl. 2000;82:192.

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

Al-Hashemy AM, Seleem MI. Appraisal of modified Alvarado score for acute appendicitis in adult. Saudi Med J. 2004;25(9):1229-31.

Denizbasi A, Unlever EE. The role of the emergency medicine resident using the Alvarado score in the diagnosis of acute appendicitis compared with the general surgery resident. Eur J Emerg Med. 2003;10(4):296-301.

Shrivastava UK, Gupta A, Sharma D. Evaluation of the Alvarado score in the diagnosis of acute appendicitis. Trop Gastroenterol. 2004;25(4):184-6.