Evaluation of Alvarado score in diagnosis and treatment of acute appendicitis

ABSTRACT

during recent years different procedures have been used to assist in the diagnosis of questionable cases of acute appendicitis. Among these methods, there are few scoring systems. The aim of this study is to evaluate Alvarado scoring system feasibility, value and accuracy as an aid in surgical decision making in cases of possible appendicitis. a prospective study involving 106 adults and 20 pediatric patients who were referred from emergency department to our surgical unit at princess haya hospital in Aqaba, Jordan with provisional diagnosis of acute appendicitis during the period August, 2001 and January, 2002. scores were determined based on the system described by alvarado. After initial evaluation, the patient either had surgery or observed in the ward. The diagnosis of appendicitis was confirmed histologically in resected specimen. the overall accuracy of Alvarado scoring system for diagnosis of appendicitis in adult male, adult female and children was 93%, 78% and 60% respectively. All patients who had an alvarado score of 9 or higher had appendicitis irrespective of age or gender. For adult male patients who scored 6 to 8, had a probability of having appendicitis equal to 93%. this probability dropped to 47% and 34% in women and children respectively Alvarado scoring system is a simple, safe and effective diagnostic aid in the management of adult male patients with suspected appendicitis while in children and adult female patients other diagnostic aids are needed