ALVARADO SCORE;

Evaluation in precise diagnosis of acute appendicitis

Abstract

Objective: To evaluate the usefulness and accuracy of Alvarado scoring system in the precise diagnosis of acute
appendicitis to decrease the rate of negative appendectomies. Design: Descriptive study. Place and duration of study: The study was
conducted in Military Hospital Rawapindi from Aug 2010 to Dec 2011. Patients and methods: In this study, initially 351 cases by
convenience sampling, were included but later 31 patients were excluded specially females because they turned out to be cases of PID ,
renal / ureteric colic or UTI . Patients with score of 4 or above underwent appendectomy. 320 patients were operated. All except
gangrenous and perforated appendices were subjected to histopathology. Six operated cases were found to be having normal
appendices. Twenty patients were treated conservatively because their scores were less than 4 according to Alvarado scoring system.
Those patients were observed till their symptoms settled. Results: Male to female ratio was 1.46:1. 71.2 %( n=196) patients were
between 13-24years. On the basis of Alvarado score 62.50 %( n=200) patients secured 7 and above while 31.25 %( n=100) were
having 4 and above score. Remaining 6.25 %( n=20) had less than 4 score. Out of total (n=300) 98 %( n=294) were histopathologically
proven to be acute appendicitis while 2 %( n=6) were of normal histopathology. Conclusions: We concluded that Alvarado Score is a
useful parameter / yardstick in diagnosis of acute appendicitis