Evaluation of Modified Alvarado Scoring System in the Diagnosis of Acute Appendicitis

Abstract

BACKGROUND Acute appendicitis is one of the most common cause of abdominal surgical emergencies. The diagnosis of acute appendicitis is clinical. Despite its frequency, the diagnosis of appendicitis is sometimes difficult. Early diagnosis and prompt operative intervention is the key for successful management of acute appendicitis. In order to reduce the negative appendicectomy rate, various scoring systems have been developed for supporting the diagnosis of acute appendicitis. The most commonly used scoring system is Alvarado score and equally its modifications. Aims and Objectives-1. To evaluate the Modified Alvarado Score System (MASS) in the diagnosis of acute appendicitis. 2. To find out sensitivity, positive and negative predictive value of MASS. 3. To find out negative appendicectomy rate. MATERIALS AND METHODSThis is a prospective study conducted in tertiary care teaching hospital in Vidarbha from November 2016 to October 2017. Total 196 patients were evaluated, of which 14 were excluded according to exclusion criteria. Therefore, 182 patients were included in this study. RESULTS182 patients were included in this study. Total 126 (67 males and 59 females) patients were operated. On histopathology, appendicitis was confirmed in 102 (58 males and 44 females) patients. Overall, sensitivity and specificity of Alvarado score was 71.57% and 45.83%. Positive and negative predictive values were found to be 84.88% and 27.5% respectively. Positive appendicectomy rate was found to be 80.95%. Overall, negative appendicectomy rate was 19.05%. CONCLUSIONAcute appendicitis is usually a clinical diagnosis and should remain one in the vast majority of patients coming with right iliac fossa pain. Alvarado scoring system is a very useful method to make a clinical diagnosis of acute appendicitis and can be arrived virtually in no time. KEYWORDS