Evaluation of Alvarado Score and Its Diagnostic Importance in Reducing Negative Appendectomy in Right Iliac Fossa Pain.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 6
Abstract
Background: Globally, acute appendicitis is a common surgical emergency1-7 with a lifetime risk of 1 in 7, which means that 6% of the individuals suffer an attack during their lifetime6-7. The condition is difficult to diagnose especially during the early stages when the classical signs and symptoms are usually subtle1-6. It has been observed that many patients undergoing appendectomy prove to be negative on histopathology. Alvarado scoring system introduced in 198612. It is based purely on history, clinical examination, some lab tests and is easy to apply. The aim of our study was to analyse the usefulness of Alvarado scoring system in Right iliac fossa and reducing the percentage of negative appendectomy. Methods: In a prospective non-randomized study including 99 patients presenting with acute onset right lilac fossa pain included in study in whom the Alvarado score was obtained at admission and categorized into three groups and group 3 and group 2 patients with deterioration underwent emergency appendectomy compared with histo-pathological diagnosis. Sensitivity, specificity, positive predictive value, negative predictive value and negative appendectomy rate calculated. Results: In our study, overall sensitivity and specificity were 98.50% and 87.09% respectively. Positive and negative predictive values were 94.36% and 96.42 respectively. Overall Negative appendectomy rate in our study was 5.9%. Conclusions: We conclude that Alvarado scoring system is easy, simple, cheap and useful tool in pre-operative diagnosis of acute appendicitis which can be used in the community by general practitioner and residents in the referral hospitals. Scores more than seven virtually confirm the diagnosis of acute appendicitis and early operation is indicated. For this reason the scoring system could be safely used by general practitioners in deciding whether to refer a patient to hospital. Patients with score 5-6 must be admitted and scored frequently.
Authors and Affiliations
Dr. Yogesh Kumar Sharma
Keywords
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