Modified Alvarado Score in Children With Diagnosis of Appendicitis

Peyvasteh, Mehran; Askarpour, Shahnam; Javaherizadeh, Hazhir; Besharati, Sepideh

doi:10.1590/0102-6720201700010014

Cited by 21 publications

(24 citation statements)

References 7 publications

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“…The Alvarado score (AS), being one of the AA diagnostic methods, has been previously used by some paediatric hospitals in Europe and the United States. It could be used as a sufficiently sensitive method together with laboratory values and ultrasonography (US) examination for early identification of AA cases in children (Ünlüer et al, 2016;Peyvasteh et al, 2017). The incidence of AA complications and the number of negative appendectomies were used to show the quality of national health care system for children with AA.…”

Section: Introductionmentioning

confidence: 99%

Laboratory Tests in Addition to the Alvarado Score in the Management of Acute Appendicitis in School-Age Children

Zviedre

Eņģelis

Tretjakovs

et al. 2019

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

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The aim of the study was to determine whether the Alvarado score (AS) together with laboratory tests could be used to distinguish patients with acute appendicitis (AA) from acute mesenteric lymphadenitis (AML). Fifty-seven patients (7–18 years) with suspected AA were included in the prospective study (October 2010 – October 2013). Thirty-one patients underwent surgery for AA and 26 were not treated surgically and were diagnosed AML on ultrasonography. AS, white blood cell count (WBC), C – reactive protein (CRP) and serum cytokines (EGF, IL-10, IL-12(p70), IL-1β, IL-4, IL-6, IL-8, IL-17, MCP-1, TNF-α) were obtained on admission and were compared between groups. Mean age of the 57 patients was 12.9 (SD 3.2). Accuracy (AR) for AS ≥ 7 alone was 73.7% for AA. Modified AS with certain serum cytokines seemed to be a reliable tool for initial differential diagnosis between AA and AML in school-age children. Based on these results, AS ≥ 7, WBC ≥ 10.7 × 103/µL and serum IL-6 ≥ 4.3 pg/mL assessed altogether will yield more sensitivity for AA. Also for further advanced diagnostics, we propose to take into account the serum IL-6, IL-8, MCP-1, CRP cut-off levels in the differential diagnosis between complicated and uncomplicated AA to decide whether the treatment should be conservative or surgical.

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Section: Introductionmentioning

confidence: 99%

Laboratory Tests in Addition to the Alvarado Score in the Management of Acute Appendicitis in School-Age Children

Zviedre

Eņģelis

Tretjakovs

et al. 2019

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

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“…A scoring system developed by Alvarado in 1896, on the basis of eight predictive clinical factors to improve the accuracy of physician's clinical assessments in diagnosing acute appendicitis. [8][9][10][11][12] It was 10-point scoring system includes clinical symptoms, signs and laboratory findings, where Alvarado recommended an operation for all patients with score 7 or more. [9][10][11][12] Later in 1994, the last point of the original score was omitted.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10][11][12] It was 10-point scoring system includes clinical symptoms, signs and laboratory findings, where Alvarado recommended an operation for all patients with score 7 or more. [9][10][11][12] Later in 1994, the last point of the original score was omitted. 13 Nowadays the Modified Alvarado Score has been widely assessed as to its accuracy in the preoperative diagnosis of acute appendicitis.…”

Section: Introductionmentioning

confidence: 99%

“…13 Nowadays the Modified Alvarado Score has been widely assessed as to its accuracy in the preoperative diagnosis of acute appendicitis. [11][12][13][14][15][16][17] However, few subsequent studies have suggested that Modified Alvarado Score is inadequate as a diagnostic tool, but it has been advocated as a means of selecting patients who should undergo imaging. 9,10,18 Therefore, present study has been attempted to assess the diagnostic efficacy of Modified Alvarado Scoring System and its relevance in present day in patients with acute appendicitis from Siliguri of Darjeeling district of West Bengal, India.…”

Section: Introductionmentioning

confidence: 99%

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Use and relevance of modified alvarado scoring system in diagnosis of acute appendicitis: a cross sectional study from West Bengal, India

Barman

Chanak

Das³

et al. 2019

Int J Adv Med

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Background: For successful management of acute appendicitis, early diagnosis and intervention is needed. Incorrect diagnosis may allow significantly increased morbidity and mortality. Several studies across the globe shows that Modified Alvarado Scoring System (MASS) does not need high end instrument and can be done in emergency situation for accessing acute appendicitis and reducing the chances of unnecessary surgery. To access the efficacy of MASS for diagnosis of acute appendicitis in remote areas with primary health care facilities, present study was done at Siliguri of Darjeeling district of West Bengal which was 580 km distant from state capital (Kolkata).Methods: A cross sectional study over a period of 16 months was conducted among the patients admitted at North Bengal Medical College and Hospital suspected to have acute appendicitis. The diagnosis was confirmed by histopathological examination. Written consent was obtained from the patients before commencement of the study. MASS was applied to the patients and the results were compared with histopathological findings. Appropriate statistical analysis has been done by SPSS (version 16.0).Results: A total of 75 patients (44 males and 31 females) were considered. The sensitivity and specificity of MASS in this study were 75.86% (71.43% for males and 80% for females) and 82.61% (80% for males and 87.5% for females) respectively. Study revealed statistically significant (p<0.000) association between Histopathological report and MASS.Conclusions: To reduce the chances of negative appendectomy and for better diagnosis of appendicitis, MASS may be more useful at primary health care centres those are located in remote areas as it was very simple, easy and cost effective.

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“…Većina autora drži da su obje metode slabe prediktivne vrijednosti i da se ne mogu rabiti kao standard za procjenu dijagnoze akutnog apendicitisa u djece. [10][11][12] U dijagnozi akutnog apendicitisa kompjutorizirana tomografi ja (CT) ima visoku senzitivnost (95 -97%) i specifi čnost (93 -99%), no negativan učinak ionizirajućeg zračenja ograničava upotrebu ove dijagnostičke metode. 13,14 Ultrazvučni pregled trbuha jako je popularna metoda, no njezina pouzdanost ovisi o puno čimbenika.…”

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Alvarado Score in Children With Diagnosis of Acute Appendicitis

2018

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Sažetak. Alvaradov sustav bodovanja osmišljen je radi smanjenja broja negativnih apendektomija. Rabi se u adultnoj i pedijatrijskoj populaciji, a broj negativnih apendektomija rijetko je manji od 10%. Kako bismo provjerili pouzdanost metode, analizirali smo korelaciju Alvaradova sustava bodovanja i histološke dijagnoze djece apendektomirane zbog sumnje na akutnu upalu crvuljka. U retrospektivnoj studiji obuhvaćeno je 330-ero djece (Zavod za dječju kirurgiju, KBC Zagreb), u razdoblju od siječnja 2014. do prosinca 2016. s kliničkom dijagnozom akutne upale crvuljka. Uključena su sva djeca neovisno o metodi apendektomije. Zbog nepotpune medicinske dokumentacije isključeno je 39-ero djece pa se u ovoj studiji analizira 291 dijete. Svaki je crvuljak postoperativno histološki pregledan u Zavodu za patologiju i citologiju KBC-a Zagreb i postavljena je konačna dijagnoza. U 160-ero djece preoperativno je načinjen ultrazvučni pregled trbuha te je zabilježena prisutnost ili odsutnost znakova upale crvuljka. Od ukupno 291 histološki pregledanog crvuljka njih 35 (12%) bilo je bez znakova upale, 44 (15,1%) bilo ih je u kataralnom stadiju upale, 153 (52,6%) fl egmonozno, a 58 (19,9%) gangrenozno promijenjeno te je u jednog dječaka (0,3%) crvuljak bio perforiran. Srednja vrijednost (bodovnog iznosa prema Alvaradovu sustavu bodovanja) za djecu koja su imala histološki nalaz inocentnog ('nevinog') crvuljka i kataralne upale jest 6, za fl egmonozne crvuljke 7, a gangrenozne 8. Dječak s perforiranim crvuljkom imao je zbroj bodova 6. Analizirane su osjetljivost, specifi čnost i pozitivna prediktivna vrijednost kada je zbroj 7 i veći, a negativna vrijednost kada je zbroj 5 i manji. Osjetljivost Alvaradova bodovnog sustava u ispitivanoj skupini jest 68,9%, a specifi čnost 52,9%. Pozitivna je prediktivna vrijednost 91,7%, a negativna 99%. Alvaradov zbroj statistički je značajno veći u djece s fl egmonoznom upalom crvuljka negoli kod onih s negativnim nalazom (p = 0,003) i kataralnom upalom (p = 0,007). Kod djece koja su imala gangrenoznu upalu crvuljka u odnosu prema inocentnim i kataralno promijenjenima također je statistički značajna razlika Alvaradova zbroja (p < 0,001). U djece s fl egmonozno i gangrenozno upalno promijenjenim crvuljkom nema statistički značajne razlike Alvaradova zbroja (p = 0,054), kao ni kod histoloških dijagnoza kataralne upale i inocentnog crvuljka (p = 0,998). Od ukupnog broja apendektomirane djece u njih 160-ero (54,9%) načinjen je preoperativni ultrazvučni pregled trbuha. Od svih ultrazvučnih nalaza njih 82 (51,2%) potvrđena su histološkom dijagnozom. Od ultrazvučnih nalaza koji nisu histološki potvrđeni bila su 64 (40%) lažno negativna i 14 (8,8%) lažno pozitivnih. Ultrazvučno pozitivan nalaz upalnih promjena crvuljka ima pozitivnu prediktivnu vrijednost 84,1%, a negativan nalaz 11,1%. Alvaradov sustav bodovanja u djece nije klinički pouzdan pokazatelj pozitivnih nalaza akutne upale crvuljka, ali ima visoku prediktivnu vrijednost negativnih apendektomija.Summary. The Alvarado scoring (AS) system was created ...

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Modified Alvarado Score in Children With Diagnosis of Appendicitis

Cited by 21 publications

References 7 publications

Laboratory Tests in Addition to the Alvarado Score in the Management of Acute Appendicitis in School-Age Children

Laboratory Tests in Addition to the Alvarado Score in the Management of Acute Appendicitis in School-Age Children

Use and relevance of modified alvarado scoring system in diagnosis of acute appendicitis: a cross sectional study from West Bengal, India

Alvarado Score in Children With Diagnosis of Acute Appendicitis

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