ABSTRACT
Background: Acute appendicitis is one of the most common causes of acute abdomen in surgical patients
Objective: To assess the diagnostic accuracy of the Alvarado score [AS] in determining acute appendicitis
Methodology: A total of 180 patients of suspected acute appendicitis were included in this study. Patients of both sexes and age groups 12 years and above were included in the study and their Alvarado scores were calculated. Patients were divided into three groups according to the AS, as AS 1-4, AS 5-6 and AS 7-10. Acute appendicitis [AA] and normal appendix [non AA] rates were compared according to the different parameters. The signs, symptoms, laboratory values, surgical interventions, and pathology reports of each patient were evaluated. Diagnosis was confirmed by histopathological examination. Sensitivity, specificity, positive and negative predictive values and diagnostic accuracy were calculated. SPSS version 16 was used for data analysis
Results: This study included 180 patients which comprised of 72 males [40%] and 108 females [60%]. 129[76.6%] patients were less than 30 years of age. Acute appendicitis rate diagnosed on histopathology reports, was 20% in patients with Alvarado score 1-4. 35.29% in Alvarado score 5-6 and 96% in Alvarado score 7-10. The negative appendicectomy rate decreased with the increase of AS. The overall diagnostic accuracy of AS in detecting acute appendicitis was 90%. The present study found no significant difference between genders, age and BMI in terms of the reliability of the AS
Conclusion: Alvarado scoring system is a useful tool in pre operative diagnosis of acute appendicitis and can work effectively in routine practice especially in resource limited settings