A study comparing modified Alvarado score and Tzanakis score for diagnosing acute appendicitis

Background: Acute appendicitis is one of the most common causes of Abdominal surgical emergencies with a lifetime prevalence of approximately 1 in 7 worldwide. It is associated with high morbidity and occasional mortality related to the failure of making an early diagnosis. Aim of the study: To compare the efficacy of Modified Alvarado Score and Tzanakis Score in Diagnosing Acute Appendicitis. Materials and methods: The study was conducted in the year 2018. Totally 100 patients between the age of 12 to 75 who presented to the General Surgery department of Govt. Royapettah Hospital with a clinical diagnosis of acute appendicitis and underwent emergency open appendicectomy were included in the study. Both Modified Alvarado Score and Zanakis score were done for all the patients at the time of admission and prior to surgery. Even the patients with scores below the cutoff values were subjected to surgery based on clinical assessment and judgment. Patients were either subjected to emergency laparotomy at the time of admission or after few hours of conservative management. Emergency appendicectomy was done by the open method under spinal or general anesthesia in all cases. Results: The mean age of patients was 22.93 years with a standard deviation of 6.86 years. 83% of patients had histologically proven appendicitis. Overall negative appendicectomy rate was 17%. The sensitivity and specificity of Modified Alvarado Score was 95.81% and 94.11% with a positive predictive value of 98.75% and the negative predictive value of 80%. The positive likely hood ratio was 16.18 and the negative likelihood ratio was 0.05. The sensitivity and specificity of Tzanakis score was 97.59% and 94.11% respectively with a positive predictive value of 98.78% and negative S. Dharmarajan, R. Arvindraj. A study comparing modified Alvarado score and Tzanakis score for diagnosing acute appendicitis. IAIM, 2019; 6(5): 137-141. Page 138 predictive value of 88.88%. The positive likely hood ratio was 16.59 and negative likelihood ratio was 0.03. Conclusion: This study shows that Tzanakis scoring system can be used as an effective modality in the establishment of accuracy in the diagnosis of acute appendicitis. There is increased sensitivity and diagnostic accuracy in Tzanakis scoring when compared to the modified Alvarado score.