Continuing Diagnostic Challenge of Acute Appendicitis: Evaluation Through Modified Alvarado Score

Malik, Ajaz Ahmad; Wani, Nazir A.

doi:10.1111/j.1445-2197.1998.tb04811.x

Cited by 52 publications

(52 citation statements)

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“…Modified Alvarado Score was neither sensitive nor specific in our study. There are studies who agree or disagree with modified Alvarado Score as its usefulness as a reliable prediction system for preoperative diagnosis of acute appendicitis 14,6,11 . In our study many of the parameters are not commonly found, thereby lower scoring of Modified Alvarado score .Lower scoring may be the result of inability of the patient to define the symptoms well for low socioeconomic status.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Modified Alvarado Score in Diagnosis of Acute Appendicitis in Adults

Mondal

Hadiuzzaman

Mukhopadhyay

et al. 2015

Bangladesh J Med Sci

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Abstract:Background: Definitive diagnosis of acute appendicitis preoperatively is sometimes difficult. Failure to make a diagnosis is the main reason for persistent rate of morbidity and mortality. Various scoring systems are devised to aid diagnosis of acute appendicitis. In some studies the modified Alvarado score was helpful, reliable and practical in minimizing unnecessary appendectomy. Objective: The purpose of this study was to evaluate the usefulness of modified Alvarado score for the diagnosis of acute appendicitis. Materials and Method: A prospective study of 89 adult patients, admitted with abdominal pain suggestive of acute appendicitis, from July 2011 to June 2012, was conducted. Data including clinical signs and symptoms and laboratory findings were recorded in modified Alvarado score record form. All 89 patients underwent appendectomy. Final diagnosis was confirmed by histopathological examination. Reliability of scoring system was assessed by negative appendectomy rate and positive predictive value. Results: Out of 89 patients who underwent appendectomy, 85 had acute appendicitis on histopathology. Positive predictive value was 95.5% and negative appendectomy rate was 4.5%. 52.8% had score 7 or above and 47.2% had score less than 7. From score it is difficult to predict which patient warranted appendectomy and who may be safely observed or discharged. Conclusions: Diagnosis of acute appendicitis remains mainly clinical evaluation and it is more helpful than modified Alvarado scoring system in adults.

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Section: Discussionmentioning

confidence: 99%

Usefulness of Modified Alvarado Score in Diagnosis of Acute Appendicitis in Adults

Mondal

Hadiuzzaman

Mukhopadhyay

et al. 2015

Bangladesh J Med Sci

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“…En muchos hospitales, aun los exámenes más simples no se encuentran disponibles las 24 h del día 2,6,10,11,[14][15][16][17][18] , o no se relacionan con la presentación clínica y hallazgos de laboratorio 9,15 . Las puntuaciones diagnósticas de AA han demostrado su valor cuando se incorporan en la práctica clínica rutinaria [27][28][29][30][31][32][33][34][35][36] . Este estudio fue diseñado con el propósito de probar la exactitud diagnósti-ca y la real utilidad de la PDA aplicada por profesionales de la salud no-médicos.…”

Section: Discussionunclassified

“…A pesar de este abordaje tecnológico todavía se operan apéndices normales y perforados 3,15 . Estas consideraciones han llevado al desarrollo de puntuaciones diagnósticas de AA, diseñadas para mejorar el diagnóstico y tratamiento precoz de AA y reducir las tasas de apendicectomías en blanco y perforadas 6,[27][28][29][30][31][32][33][34][35][36] , ambas circunstancias tienen consecuencias en términos de complicaciones, costos e implicaciones legales 3,37 . La más conocida de estas puntuaciones es el Score de Alvarado (SA) 32 .…”

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“…Tiene las ventajas de su simplicidad, es fácilmente comprensible, no-invasivo y costo-efectivo [31][32][33]38 . El gran número de escalas y puntuaciones diagnósticas para AA, desarrolladas en diferentes instituciones [27][28][29][30][31][32][33][34][35][36] , demuestra la elevada incertidumbre para el diagnóstico de AA que prevalece entre los médicos de las unidades de emergencias (UE). La utilidad demostrada por estas puntuaciones se debe al hecho de que los médicos deben enfocarse en la información clínica específica disponible e incorporarla en el análisis del paciente 4 .…”

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Puntuación diagnóstica para apendicitis: estudio prospectivo de su aplicación por profesionales de salud no-médicos

Beltrán¹,

M²,

Cruces³

2006

Rev. méd. Chile

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“…reported negative appendectomy rates to be 32.5%, it has been determined that for cases with Alvarado score equal to and above 7 this rate decreases to 18.8%. Since Alvarado score is 6 or lower for 80% of the negative appendectomies, it is thought that the use of the scoring system especially for children and the elder would decrease negative appendectomy and perforations (24). In a study carried out by Zielke et.…”

Section: Discussionmentioning

confidence: 99%

The place of scoring systems for the diagnosis of acute appendicitis a retrospective cohort study

Namdaroğlu¹,

Öter²,

Karabeyoglu³

2018

J Turgut Ozal Med Cent

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Aim: Acute appendicitis is among the most frequently observed reasons of abdominal pain. The high rate of dubiousness in diagnosis, high rate of negative appendectomy led to the introduction of scoring systems. Despite today's advanced imaging methods and various scoring methods like Alvarado, making the diagnosis may not always be easy. On the other hand, negative appendectomy rate is reported to be 15-30%. Therefore accurate and rapid diagnosis is fundamental in acute appendicitis. In our study we aimed to determine the place of scoring systems defined by Alvarado, Ohmann and Eskelinen for the diagnosis of acute appendicitis and their efficacy in lowering negative appendectomy rates. Material and Methods: In our study, 120 patients who were operated as a result of diagnosis of acute appendicitis between May-2011 and July-2011 were retrospectively evaluated. Patients' Alvarado, Ohmann and Eskelinen scores were calculated for evaluation. Result: It was seen that there was a statistically significant between high Alvarado and Ohmann scores and pathological acute appendicitis. Considering Eskelinen score, significant difference could not be determined. Discussion: In conclusion, Alvarado, Ohmann and Eskelinen scoring systems were evaluated with regard to acute appendicitis and found a meaningful relationship between Alvarado and Ohmann scoring systems and the acute appendicitisit is thought that the use of the scoring system especially for children and the elder would decrease negative appendectomy and perforations. In addition, its coefficients which create a calculation difficulty in practical use limit the use of this scoring system in emergencies which work intensively.

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Continuing Diagnostic Challenge of Acute Appendicitis: Evaluation Through Modified Alvarado Score

Cited by 52 publications

References 3 publications

Usefulness of Modified Alvarado Score in Diagnosis of Acute Appendicitis in Adults

Usefulness of Modified Alvarado Score in Diagnosis of Acute Appendicitis in Adults

Puntuación diagnóstica para apendicitis: estudio prospectivo de su aplicación por profesionales de salud no-médicos

The place of scoring systems for the diagnosis of acute appendicitis a retrospective cohort study

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