Acute Appendicitis:Role of Alverado Scoring System in the Diagnosis

Abstract

Background: Acute appendicitis is a common surgical emergency. This study was conducted to evaluate the role of Alverado scoring system in diagnosing acute appendicitis.

Material & Methods: It was an observational study conducted at Surgical Ward, DHQ Teaching Hospital, D.I.Khan, from 1st April 2008 to 31st March 2009. Two hundred consecutive adult patients admitted through emergency and OPD suspected of having acute appendicitis were analyzed. The role of Alverado scoring system in diagnosis was evaluated. The operative findings were recorded and appendices were subjected to histopathological examination for confirmation of the diagnosis.

Results: On Alverado scoring 76 patients were having score of 7-10 and underwent emergency surgery. Ninety-four patients were having score of 5-6 and were observed. Twenty of these improved and were discharged home, while 74 remained with the same score and underwent surgery. Thirty patients were having score of 1-4 and were discharged home. Out of 50 patients discharged home, 10 were re-admitted with increased score and underwent surgery. Eight of these were confirmed by histopathology as having appendicitis. The sensitivity of the system was calculated as 94.16% and specificity 66.66%, with a positive predictive value of 86% and negative predictive value of 84%.

Conclusion: Alverado Scoring System is a simple and effective system for the diagnosis of acute appendicitis, especially in periphery hospitals where modern investigative facilities are not available.