ACUTE APPENDICITIS

EFFICACY OF COMPLETE CLINICAL EVALUATION AND MODIFIED ALVARADO SCORING SYSTEM IN DIAGNOSE

Abstract

Objectives: The objective of this study was to compare the efficacy of Clinical
Evaluation and modified Alvarado scoring system in diagnosing acute appendicitis. Study
Design: Cross sectional study. Place and Duration of Study: This study was conducted at
Surgical Unit III of Civil Hospital Karachi from May 2010 to October 2010. Methodology: This
study consisted of eighty patients. Patients were divided in two groups. Group A for complete
clinical evaluation comprising of 40 patients and Group B for modified Alvarado scoring system
comprising of 40 patients. Inclusion criteria were all patients presenting with RIF pain, nausea,
vomiting, fever and/or anorexia, diagnosed as having acute appendicitis preoperatively and
undergoing emergency appendectomy during this period, age >12 years and both gender.
Exclusion criteria included not willing for surgery, General anesthesia problem, pregnant female
patients and those who did not give written consent. Results: A total of 80 patients were included
in the study, placed alternatively into two groups of 40 patients each with majority being male
(n = 61, 76.3%). The mean age was 22.46 years. The positive predictive value for patients of
Group A was 92.5% while for Group B was 77.5%. When diagnostic accuracy was compared on
the basis of Gender for the two groups, the positive predictive value for male patients of Group
A and B was 90.09% and 89.28% respectively, but for females the positive predictive value
of Group A and B was 100% and 50% respectively. Conclusion: We conclude that modified
Alvarado score can be used safely and effectively in diagnosing acute appendicitis in adult
males especially as the score increases from seven to nine.