Alvarado score: can it reduce unnecessary interventions for acute appendicitis in children?

Abstract

The purpose of the study is to compare the outcomes of surgical interventions for acute appendicitis with the values of the Alvarado score. We conducted the study on 572 patients that underwent surgical interventions for acute appendicitis. Retrospectively, based on the medical records, we calculated the MANTRELS score and compared the outcomes of the intervention with the values of the applied score. Almost one third of the patients with a MANTRELS score lower than 6 had negative appendectomies. These patients represent 60% of the total cases of negative appendectomies, while in the case of patients with a high score around 2% had negative appendectomies. We concluded that using this scoring system to assess the need of immediate surgical intervention is important and can increase the rate of positive diagnosis mainly by limiting the number of unnecessary interventions.

Clinical Approach in the Diagnosis of Acute Appendicitis

“…Chisalau et al [31] conducted a retrospective study in 572 children that underwent surgery for acute appendicitis using the Alvarado score. They found that 16.3% had a negative appendectomy, and that almost all patients with a high score confirmed the diagnosis after surgical intervention.…”