Role of Modified Alvarado Score in the Diagnosis of Acute Appendicitis

Abstract

Introduction: Acute appendicitis is one of the most common acute digestive diseases presenting in the Emergency Departments worldwide. In spite of advances in the diagnostic modalities and surgical techniques diagnosing acute appendicitis always remains a challenge and delay in decision making may complicate a supposedly simple surgical disease. The diagnosis is all the more complicated in females. Modified Alvarado Scoring System (MASS) is a cheap and quick diagnostic modality which does not need any high end instruments and can be done in the emergency set-up and even in odd hours of night. Aim: To test the efficacy and diagnostic accuracy of MASS in the diagnosis of acute appendicitis. Materials and Methods: Prospective cross–sectional type of study was conducted from January 2015 to December 2015 in the Department of General Surgery. A total of ninety three adult patients (fifty five males and thirty eight females) were enrolled in the study. Sensitivity, specificity, Positive predictive value and Negative predictive value of MASS were found separately in males and compared with those of females to see the efficacy of MASS in the diagnosis of acute appendicitis. Results: Most of the patients having a MASS of 7 or higher were found to have acute appendicitis in comparison to those having score <7. The sensitivity and specificity of MASS were 93.24%, 84.21 %, with acceptable Positive and Negative predictive values 5.91 and 0.08 respectively. Conclusion: The Modified Alvarado Scoring System is a simple and efficient diagnostic tool for the diagnosis of acute appendicitis with acceptable sensitivity and specificity and can be used with good degree of accuracy

Keywords

• appendicular pathology
• diagnostic modalities
• scoring systems