The Validity of Alvarado Score in Diagnosis of Acute Appendicitis among Sudanese Patients

Abdelrahim, Mohanad; Khair, Randa Z A M

doi:10.4172/2161-1076.1000257

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…Most of the study cohort scored above Alvarado score of 5 (91%), and about 65% of the study population obtained a score of 7. Other studies showed a similar finding that most of the study population presented with a score above 5 [ 33 , 36 , 39 , 40 ]. We examined the sensitivity and specificity of the Alvarado score at the cutoff point of 5 and 7.…”

Section: Discussionsupporting

confidence: 72%

The Role of Alvarado Score in Predicting Acute Appendicitis and Its Severity in Correlation to Histopathology: A Retrospective Study in a Qatar Population

Al‐Tarakji¹,

Zarour²,

Singh³

et al. 2022

Cureus

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Background/objectiveAcute appendicitis (AA) is one of the most common surgical emergencies that require a proper diagnosis to avoid a negative outcome in the case of missed or delayed diagnosis. Our study aims to assess the diagnostic power of the Alvarado score and the prediction of the severity of acute appendicitis in correlation to intraoperative findings and the final histopathology (HP) result. MethodsThis retrospective study was applied to 1,303 patients with clinically proven acute appendicitis (AA) and available HP results. We correlated Alvarado score to the gold standard HP and intraoperative findings. We selected the cutoff point of Alvarado at 5 and 7 as they were the most frequent cutoff value mentioned in the literature and based on the ROC curve in this study to assess sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). ResultsThe mean age of the study cohort is 33.3 ± 9.5 years, with a male predominance (75.8%). The negative appendectomy (NA) rate was 4%. The operative complication rate was 1.2%, and we recorded one mortality case (0.1%). The diagnostic evidence of AA was in 95.9% of cases. Alvarado score ≥ 7 presented sensitivity and specificity of 66.4% and 69.8%, respectively, with PPV of 98.1% and NPV of 8.1%, with an accuracy of 66.5%. For Alvarado score ≥ 5, the sensitivity was 91.2%, specificity was 22.6%, PPV was 96.5%, NPV was 9.8%, and accuracy was 88.4%. In addition, we demonstrated statistical significance between Alvarado risk stratification with HP and intraoperative grades (p = 0.001 each). ConclusionThe Alvarado scoring system alone is not enough to diagnose AA with unsatisfactory sensitivity and specificity. However, it is a good indicator of the severity of AA that we can depend on to prioritize those patients waiting for surgery.

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Section: Discussionsupporting

confidence: 72%

The Role of Alvarado Score in Predicting Acute Appendicitis and Its Severity in Correlation to Histopathology: A Retrospective Study in a Qatar Population

Al‐Tarakji¹,

Zarour²,

Singh³

et al. 2022

Cureus

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“…The same happened with the Brazilian study by Sousa-Rodrigues et al 21 in which the elevation of temperature occurred in a greater proportion, The most prevalent Alvarado scores were six, five and seven points, and the majority of the studied population presented a score greater than or equal to five, lower than those found by Sousa-Rodrigues et al 21 , in which the most prevalent were seven, eight and six points, respectively. Abdelrahim et al 27 presented more prevalent scores greater than or equal to seven, and the same happened with a study in the South African population 28 , which added higher points to the score. On the other hand, Memon et al 25 found data similar to ours, the majority of patients displaying a score of five or six.…”

Section: Discussionmentioning

confidence: 53%

“…In a study by Quesada Suárez et al 29 , the diagnosis was confirmed in 86%, and of those submitted to non-therapeutic appendectomy, the majority presented scores between five and seven. In a study by Abdelrahim et al 27 , all patients submitted to non-therapeutic appendectomy had a score below seven. In the present study, all unconfirmed patients had a score less than or equal to five, with the exception of one patient, who scored nine points.…”

Section: Discussionmentioning

confidence: 95%

Associação entre o escore de Alvarado, achados cirúrgicos e aspecto histopatológico da apendicite aguda.

Nascimento

Souza

Alexandre

et al. 2018

Rev. Col. Bras. Cir.

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RESUMO Objetivo: comparar o resultado do escore de Alvarado com os achados cirúrgicos e com os resultados do exame histopatológico do apêndice de pacientes operados por apendicite aguda. Métodos: estudo observacional com delineamento transversal de 101 pacientes com 14 anos de idade ou mais, submetidos à apendicectomia de urgência. A avaliação continha o escore de Alvarado, pontuação no escore, sexo, idade, etnia dos pacientes e tempo de evolução. Foi obtido o aspecto cirúrgico do apêndice, dados a respeito das complicações pós-operatórias e o resultado do exame histopatológico. O intervalo de confiança pré-estabelecido foi de 95%. Foram calculadas sensibilidade, especificidade, valor preditivo positivo e negativo do escore, e realizada uma análise através da curva ROC. Resultados: a associação entre o escore de Alvarado e a confirmação diagnóstica utilizando como ponto de corte uma pontuação maior ou igual a seis encontrou-se significância estatística (P=0,002), com sensibilidade de 72% e especificidade de 87,5%. A pontuação maior ou igual a seis mostrou maior tendência a apresentar fases mais avançadas da apendicite aguda tanto no aspecto cirúrgico quanto histopatológico, quando comparado a uma pontuação menor que seis. O sexo masculino apresentou maiores chances de complicações quando comparado ao sexo feminino (P=0,003). Conclusão: o escore de Alvarado se mostrou um bom método para triagem diagnóstica na apendicite aguda, já que pontuações maiores ou iguais a seis estão associadas a uma probabilidade maior de confirmação diagnóstica e de quadros mais avançados da doença aguda.

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“…At a cutoff point of 3, the Alvarado score was found to be accurate to rule out acute appendicitis. A negative appendectomy was found in 7.1%, all below 7 of the score, while 37% of patients had a complicated appendectomy with a score of 7 or above [46].…”

Section: Acute Appendicitis In Developing Countriesmentioning

confidence: 93%

Clinical Approach in the Diagnosis of Acute Appendicitis

A¹

2018

Current Issues in the Diagnostics and Treatment of Acute Appendicitis

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The Validity of Alvarado Score in Diagnosis of Acute Appendicitis among Sudanese Patients

Cited by 5 publications

References 5 publications

The Role of Alvarado Score in Predicting Acute Appendicitis and Its Severity in Correlation to Histopathology: A Retrospective Study in a Qatar Population

The Role of Alvarado Score in Predicting Acute Appendicitis and Its Severity in Correlation to Histopathology: A Retrospective Study in a Qatar Population

Associação entre o escore de Alvarado, achados cirúrgicos e aspecto histopatológico da apendicite aguda.

Clinical Approach in the Diagnosis of Acute Appendicitis

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