Efficacy of Modified Alvarado Scoring in Acute Appendicitis
Introduction: Acute appendicitis is an acute inflammation of the appendix. Acute appendicitis is a common presentation and appendectomy accounts for a large number of emergency operations. It is not an easy diagnosis to make and eludes many surgeons. A failure of early diagnosis can lead to progression of the disease with increased morbidity and occasional mortality. The gold standard for diagnosis is the pathological assessment of resected specimen. Clinical scores were designed to improve the diagnostic accuracy (DA) of acute appendicitis. However, their results vary when applied in different populations. On looking up the literature, we found that the negative appendectomy rates have been consistently maintained all through these years. Decision-making in patients with acute appendicitis poses a diagnostic challenge worldwide despite much advancement in abdominal surgery. The following study was, therefore, taken up to evaluate the DA of the modified Alvarado scoring system.
Materials and Methods: A total of 30 patients were analyzed for this prospective study between September 2019 and December 2019 at KIMS, Narketpally. All patients diagnosed as acute appendicitis were evaluated with a modified Alvarado score (MAS). Patients with a score of 7–9 were taken up for surgery. Patients with score <7, but with high suspicion of appendicitis by the surgeon, were taken up for surgery. Following surgery, all appendix specimens were sent for histopathological examination, and the scoring system was then compared to the histological examination.
Results: Of the 30 patients, 26 were male and four were female. Sensitivity of the scoring system was specificity of the scoring system was 63.3%.
Conclusion: MAS is not as accurate as previously considered. It is not an ideal screening for accurate diagnosis of acute appendicitis.