Dolor en fosa ilíaca derecha y Score de Alvarado

Canavosso, Lucas; Carena, Pablo; Carbonell, Juan Manuel; Monjo, Luciano; C, Zuñiga; Sánchez, Martín; Lada, Paul Eduardo

doi:10.1016/s0009-739x(08)70562-1

Cited by 15 publications

(13 citation statements)

References 17 publications

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“…The Alvarado score discriminated well as an observation/admission criterion (cut point of 5) by achieving high pooled sensitivity of 99% overall (n = 28 studies, [5,8,10,) and in studies where data were available, it also performed well in the subgroup analysis for men, woman and children (pooled sensitivities: 0.96 for men, n = 5 [23,30,[33][34][35]; 0.99 for women, n = 5 [23,30,34,35,43] and 0.99 for children, n = 9 [10,21,23,27,28,30,[40][41][42]) ( Table 2 and Additional file 1 - Figure S1). In patients presenting with higher Alvarado scores (cut point of 7, the criterion for surgery), pooled diagnostic accuracy results had more limited clinical value (pooled specificity for all studies 0.82, n = 29, [5,8,10,11,[18][19][20][21][22][23][24][25][27][28][29][30][31][32][34][35][36]…”

Section: Diagnostic Accuracy Of the Alvarado Scorementioning

confidence: 93%

“…In patients presenting with higher Alvarado scores (cut point of 7, the criterion for surgery), pooled diagnostic accuracy results had more limited clinical value (pooled specificity for all studies 0.82, n = 29, [5,8,10,11,[18][19][20][21][22][23][24][25][27][28][29][30][31][32][34][35][36][37][38]41,42,[44][45][46][47]), with pooled specificities ranging from 0.57 for subgroup analysis of men (n = 6, [9,23,30,34,35,45] Figure S1). Overall, heterogeneity was high when all studies were included and was particularly high in the children subgroup as indicated by the variance logit transformed sensitivity and specificity (Table 2) and the prediction ellipses on the SROC curves Additional file 1 - Figure S1).…”

Section: Diagnostic Accuracy Of the Alvarado Scorementioning

confidence: 99%

“…Heterogeneity in terms of betweenstudy predicted/observed risk ratio estimates is apparent in children across all risk strata and in women at a high risk (I 2 > 50%), and, therefore, these pooled estimates should be treated with caution. In a subgroup analysis based on prevalence (Additional file 1 - Figure S2), the high prevalence category consisted of six studies [9,10,23,32,37,39] -the score predicted well in this group and heterogeneity was below 50% in the high and low risk groups (low risk RR 0.65, 95% CI 0.25 to 1.75, I 2 = 34%; intermediate risk RR 0.99, 95% CI 0.70 to 1.40, I 2 = 72%; high risk RR 0.99, 95% CI 0.96 to 1.02, I 2 = 0%). The low prevalence subgroup consisted of 24 studies, there was a significant overprediction across all risk strata; however, heterogeneity was extremely high (I 2 = 78% to 85%) suggesting that other factors, perhaps age and gender, contributed to the high levels of heterogeneity in this group.…”

Section: Calibration Of the Alvarado Scorementioning

confidence: 99%

See 2 more Smart Citations

High white blood cell count and erythrocyte sedimentation rate are associated with perforated appendicitis in children

Kim¹,

Woo²,

Lee³

et al. 2017

Pediatr Emerg Med J

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Section: Diagnostic Accuracy Of the Alvarado Scorementioning

confidence: 93%

Section: Diagnostic Accuracy Of the Alvarado Scorementioning

confidence: 99%

Section: Calibration Of the Alvarado Scorementioning

confidence: 99%

See 1 more Smart Citation

High white blood cell count and erythrocyte sedimentation rate are associated with perforated appendicitis in children

Kim¹,

Woo²,

Lee³

et al. 2017

Pediatr Emerg Med J

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“…Por otra parte, los pacientes con puntuacio nes de 4 o menos deben ser dados de alta y citados para control a las 24 horas. Una propuesta similar de manejo, de Cannavosso, et al (22) , se presenta en la figura 2.…”

Section: Criterio Valorunclassified

Utility of Alvarado´s Score in Acute Appendicitis at Hospital De Clinicas - Paraguay

2017

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RESUMENObjetivo. Evaluar las puntuaciones de la escala de Alvarado en una serie de casos intervenidos quirúrgicamente con diagnóstico de apendicitis aguda.Materiales y métodos. Estudio descriptivo de corte transversal. Se revisaron historias de 159 pacientes sometidos a cirugía con diagnóstico de apendicitis aguda, de enero a junio de 2015. Se estimó la puntuación alcanzada en la escala de Alvarado y se correlacionó con el resultado histopatológico, tiempo de evolución, sexo y edad.Resultados. El 56,6 % correspondió a hombres y el promedio de edad de 38,4 años. El tiempo de evolución registró un promedio de 36 horas para las mujeres y 40,75 horas para los hombres. En el 94% de los casos presentaban dolor en fosa ilíaca derecha, 48% fiebre graduada, 77% náuseas o vómitos, 96% signo de Blumberg positivo, 81% anorexia, 77% migración del dolor, 78,8% leucocitosis, 88,4% neutrofilia. La media registrada con la escala de Alvarado fue de 8; 7,89 en mujeres y 7,91 en hombres. Hubo concordancia diagnóstica del 98% entre la escala de Alvarado y resultado histopatológico.Conclusión. La escala de Alvarado puede ser una herramienta útil para mejorar la eficiencia diagnóstica en la apendicitis aguda, sobre todo en los servicios de atención ambulatoria y urgencias.Palabras Claves: Apendicitis aguda, Escala diagnóstica de Alvarado, Abdomen agudo quirúrgico. SUMMARY Objective:Evaluate the scale scores of Alvarado in a series of cases operated on with diagnosis of acute appendicitis.Materials and methods. A descriptive cross-sectional study. 159 stories were reviewed of patients undergoing surgery with a diagnosis of acute appendicitis, from January to June 2015. It was felt the score attained in the scale of Alvarado and correlated with the histopathological result, time of evolution, sex and age.Results. The 56.6 % were men and the average age of 38.4 years. The time of evolution, an average of 36 hours for 40.75 hours for women and men. In 94% of cases presented pain in the right iliac fossa, 48% 77% graduate fever, nausea or vomiting, 96% positive sign of Blumberg, 81% anorexia, 77% migration of pain, 78.8% leukocytosis, 88.4% neutrophilia. The average recorded with the scale of Alvarado was of 8; 7.91 7.89 in women and in men. There were 98% of the diagnostic concordance between the scale of Alvarado and histopathological result.Conclusion. The scale of Alvarado can be a useful tool to improve diagnostic efficiency in acute appendicitis, especially in ambulatory care services and emergency services.Keywords: Acute appendicitis, Scale of Alvarado, Acute surgical abdomen. INTRODUCCIÓN La primera apendicectomía reportada se practicó en 1735(1), y la descripción histopatológica de la inflamación del apéndice y posterior evolución hacia peritonitis fue publicada por R. H. Fitz, en 1886 (2). En la actualidad, se reconoce que la apendicitis aguda afecta a 7 % de cual quier población, sin ajustar por sexo, aunque se reporta mayor frecuencia en los hombres, lo que hace de ella la urgencia quirúrgica abdominal más frecuente en las ins...

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“…Un dolor localizado en el cuadrante inferior derecho es una consulta habitual en el servicio de urgencias, siendo la apendicitis una de las etiologías más comunes (1). Sin embargo, del 20 al 33 % se presenta de manera atípica, por lo que es un verdadero desafío diagnóstico (1,2).…”

Section: Introductionunclassified