Literature DB >> 25542452

Alvarado score: can it reduce unnecessary CT scans for evaluation of acute appendicitis?

Piyaporn Apisarnthanarak1, Voraparee Suvannarerg1, Poompis Pattaranutaporn1, Aphinya Charoensak1, Steven S Raman2, Anucha Apisarnthanarak3.   

Abstract

OBJECTIVE: The objective of the study is to assess the utility of Alvarado score in the diagnosis of acute appendicitis and the utility of computed tomographic (CT) scan for evaluation of acute appendicitis when stratified by Alvarado scores.
MATERIALS AND METHODS: Retrospective cohort study comprised adult patients who underwent abdominal CT for suspected acute appendicitis between January 2006 and December 2009. Two abdominal radiologists independently reviewed the CT scans; any discrepancies were resolved by a consensus review. Alvarado scores were calculated and categorized as low (0-3), equivocal (4-6), or high (7-10) probability for appendicitis. The diagnostic utility of CT scans and Alvarado score for acute appendicitis were compared with the criterion standard of combined medical chart review and pathology findings.
RESULTS: In a cohort of 158 subjects, 73 (46.2%) had clinical diagnoses of acute appendicitis. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CT scan in the diagnosis of acute appendicitis were 97.5%, 98.6%, 96.5%, 96.0%, and 98.8%, respectively. The mean Alvarado score for subjects with complicated appendicitis was significantly higher (7.95) than subjects with uncomplicated appendicitis (6.67) and those with other diagnoses (5.95). Acute appendicitis was confirmed in 2 (13.3%) of 15 subjects with low probability Alvarado scores, 16 (30.8%) of 52 subjects with equivocal scores, and 55 (60.4%) of 91 subjects with high probability scores.
CONCLUSION: The CT scan had high diagnostic utility for acute appendicitis. The Alvarado score was not a reliable independent predictive tool for acute appendicitis and could not replace CT scan.
Copyright © 2014 Elsevier Inc. All rights reserved.

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Year:  2014        PMID: 25542452     DOI: 10.1016/j.ajem.2014.11.056

Source DB:  PubMed          Journal:  Am J Emerg Med        ISSN: 0735-6757            Impact factor:   2.469


  9 in total

1.  Trends in the Use of Medical Imaging to Diagnose Appendicitis at an Academic Medical Center.

Authors:  Michael D Repplinger; Andrew C Weber; Perry J Pickhardt; Victoria P Rajamanickam; James E Svenson; William J Ehlenbach; Ryan P Westergaard; Scott B Reeder; Elizabeth A Jacobs
Journal:  J Am Coll Radiol       Date:  2016-04-02       Impact factor: 5.532

2.  A comparative study on the diagnostic validity of three scoring systems in the diagnosis of acute appendicitis in emergency centres.

Authors:  Farahnaz Farahbakhsh; Mehdi Torabi; Moghaddameh Mirzaee
Journal:  Afr J Emerg Med       Date:  2020-05-30

3.  Application of scoring systems with point-of-care ultrasonography for bedside diagnosis of appendicitis.

Authors:  Erden Erol Ünlüer; Rıfat Urnal; Utku Eser; Serkan Bilgin; Mehmet Hacıyanlı; Orhan Oyar; Haldun Akoğlu; Arif Karagöz
Journal:  World J Emerg Med       Date:  2016

4.  Prospective Observational Study on acute Appendicitis Worldwide (POSAW).

Authors:  Massimo Sartelli; Gian L Baiocchi; Salomone Di Saverio; Francesco Ferrara; Francesco M Labricciosa; Luca Ansaloni; Federico Coccolini; Deepak Vijayan; Ashraf Abbas; Hariscine K Abongwa; John Agboola; Adamu Ahmed; Lali Akhmeteli; Nezih Akkapulu; Seckin Akkucuk; Fatih Altintoprak; Aurelia L Andreiev; Dimitrios Anyfantakis; Boiko Atanasov; Miklosh Bala; Dimitrios Balalis; Oussama Baraket; Giovanni Bellanova; Marcelo Beltran; Renato Bessa Melo; Roberto Bini; Konstantinos Bouliaris; Daniele Brunelli; Adrian Castillo; Marco Catani; Asri Che Jusoh; Alain Chichom-Mefire; Gianfranco Cocorullo; Raul Coimbra; Elif Colak; Silvia Costa; Koray Das; Samir Delibegovic; Zaza Demetrashvili; Isidoro Di Carlo; Nadezda Kiseleva; Tamer El Zalabany; Mario Faro; Margarida Ferreira; Gustavo P Fraga; Mahir Gachabayov; Wagih M Ghnnam; Teresa Giménez Maurel; Georgios Gkiokas; Carlos A Gomes; Ewen Griffiths; Ali Guner; Sanjay Gupta; Andreas Hecker; Elcio S Hirano; Adrien Hodonou; Martin Hutan; Orestis Ioannidis; Arda Isik; Georgy Ivakhov; Sumita Jain; Mantas Jokubauskas; Aleksandar Karamarkovic; Saila Kauhanen; Robin Kaushik; Alfie Kavalakat; Jakub Kenig; Vladimir Khokha; Desmond Khor; Dennis Kim; Jae I Kim; Victor Kong; Konstantinos Lasithiotakis; Pedro Leão; Miguel Leon; Andrey Litvin; Varut Lohsiriwat; Eudaldo López-Tomassetti Fernandez; Eftychios Lostoridis; James Maciel; Piotr Major; Ana Dimova; Dimitrios Manatakis; Athanasio Marinis; Aleix Martinez-Perez; Sanjay Marwah; Michael McFarlane; Cristian Mesina; Michał Pędziwiatr; Nickos Michalopoulos; Evangelos Misiakos; Ali Mohamedahmed; Radu Moldovanu; Giulia Montori; Raghuveer Mysore Narayana; Ionut Negoi; Ioannis Nikolopoulos; Giuseppe Novelli; Viktors Novikovs; Iyiade Olaoye; Abdelkarim Omari; Carlos A Ordoñez; Mouaqit Ouadii; Zeynep Ozkan; Ajay Pal; Gian M Palini; Lars I Partecke; Francesco Pata; Michał Pędziwiatr; Gerson A Pereira Júnior; Tadeja Pintar; Magdalena Pisarska; Cesar F Ploneda-Valencia; Konstantinos Pouggouras; Vinod Prabhu; Padmakumar Ramakrishnapillai; Jean-Marc Regimbeau; Marianne Reitz; Daniel Rios-Cruz; Sten Saar; Boris Sakakushev; Charalampos Seretis; Alexander Sazhin; Vishal Shelat; Matej Skrovina; Dmitry Smirnov; Charalampos Spyropoulos; Marcin Strzałka; Peep Talving; Ricardo A Teixeira Gonsaga; George Theobald; Gia Tomadze; Myftar Torba; Cristian Tranà; Jan Ulrych; Mustafa Y Uzunoğlu; Alin Vasilescu; Savino Occhionorelli; Aurélien Venara; Andras Vereczkei; Nereo Vettoretto; Nutu Vlad; Maciej Walędziak; Tonguç U Yilmaz; Kuo-Ching Yuan; Cui Yunfeng; Justas Zilinskas; Gérard Grelpois; Fausto Catena
Journal:  World J Emerg Surg       Date:  2018-04-16       Impact factor: 5.469

5.  Risk factors associated with perforated acute appendicitis in geriatric emergency patients.

Authors:  Siriwimon Tantarattanapong; Nuraianee Arwae
Journal:  Open Access Emerg Med       Date:  2018-10-04

6.  Evaluation of the diagnostic performance of a decision tree model in suspected acute appendicitis with equivocal preoperative computed tomography findings compared with Alvarado, Eskelinen, and adult appendicitis scores: A STARD compliant article.

Authors:  Hyo Jung Kang; Hyuncheol Kang; Bohyun Kim; Min Seok Chae; Young Rock Ha; Seong Beom Oh; Jung Hwan Ahn
Journal:  Medicine (Baltimore)       Date:  2019-10       Impact factor: 1.889

Review 7.  Can The 'Speed Bump Sign' Be a Diagnostic Tool for Acute Appendicitis? Evidence-Based Appraisal by Meta-Analysis and GRADE.

Authors:  Ling Wang; Ching-Hsien Ling; Pei-Chun Lai; Yen-Ta Huang
Journal:  Life (Basel)       Date:  2022-01-18

8.  Diagnostic accuracy of Alvarado scoring system relative to histopathological diagnosis for acute appendicitis: A retrospective cohort study.

Authors:  Muhammad Tayyab Naeem; Muhammad Amir Jamil; Muhammad Imran Anwar; Hassan Raza; Ali Asad; Hashaam Jamil; Muhammad Junaid Tahir; Jharna Bai; Tabssum Mohamad Ejaz Chauhan; Muhammad Sohaib Asghar
Journal:  Ann Med Surg (Lond)       Date:  2022-09-02

9.  Predictive Factors to Distinguish Between Patients With Noncomplicated Appendicitis and Those With Complicated Appendicitis.

Authors:  Tae Hyung Kim; Byung Sun Cho; Jae Hag Jung; Moon Soo Lee; Je Ho Jang; Chang Nam Kim
Journal:  Ann Coloproctol       Date:  2015-10-31
  9 in total

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