OBJECTIVE: To evaluate the diagnostic accuracy of Alvarado score for the prediction of acute appendicitis. STUDY DESIGN: Analytical study. PLACE AND DURATION OF STUDY: This study was carried out in the Department of Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, during the period from January 15, 2009 to July 15, 2010. METHODOLOGY: The study included all adult patients of either gender who presented with clinical findings suggestive of acute appendicitis, who were assigned Alvarado score of < 4 pre-operatively and subsequently underwent emergency appendicectomy with histological examination of the resected specimens. Based on the Alvarado score, the patients were stratified into two groups. i.e. Group I (with a score of > 7) and Group II (with a score of 5-7). Alvarado score was compared with the histopathology. The data was subjected to statistical analysis to measure the objective. RESULTS: The overall sensitivity, specificity, positive predictive value and negative predictive value of Alvarado score for acute appendicitis were 66%, 81%, 96%, 29% respectively. The sensitivity was higher though not significant, for males with a score over 7 than females with similar scores (97% vs. 92%). However, for scores less than 7, sensitivity among males was significantly higher than females with similar scores (79% vs. 61%; p < 0.05). CONCLUSION: The presence of a high Alvarado score in adult males is highly predictive of acute appendicitis, however, in women of child bearing age other causes of similar clinical presentation lead to a low diagnostic accuracy of the score.
OBJECTIVE: To evaluate the diagnostic accuracy of Alvarado score for the prediction of acute appendicitis. STUDY DESIGN: Analytical study. PLACE AND DURATION OF STUDY: This study was carried out in the Department of Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, during the period from January 15, 2009 to July 15, 2010. METHODOLOGY: The study included all adult patients of either gender who presented with clinical findings suggestive of acute appendicitis, who were assigned Alvarado score of < 4 pre-operatively and subsequently underwent emergency appendicectomy with histological examination of the resected specimens. Based on the Alvarado score, the patients were stratified into two groups. i.e. Group I (with a score of > 7) and Group II (with a score of 5-7). Alvarado score was compared with the histopathology. The data was subjected to statistical analysis to measure the objective. RESULTS: The overall sensitivity, specificity, positive predictive value and negative predictive value of Alvarado score for acute appendicitis were 66%, 81%, 96%, 29% respectively. The sensitivity was higher though not significant, for males with a score over 7 than females with similar scores (97% vs. 92%). However, for scores less than 7, sensitivity among males was significantly higher than females with similar scores (79% vs. 61%; p < 0.05). CONCLUSION: The presence of a high Alvarado score in adult males is highly predictive of acute appendicitis, however, in women of child bearing age other causes of similar clinical presentation lead to a low diagnostic accuracy of the score.
Authors: Muhammad Usman Malik; Tara M Connelly; Faisal Awan; Frederik Pretorius; Constantino Fiuza-Castineira; Osama El Faedy; Paul Balfe Journal: Int J Colorectal Dis Date: 2016-12-15 Impact factor: 2.571