The Accuracy of Alvarado Score in Diagnosis of Adult Acute Appendicitis
Keywords:
Acute appendicitis, Alvarado score, The Accuracy DiagnosisAbstract
To investigate the accuracy of Alvarado score for the diagnosis of acute appendicitis with Pathology results.
Methods Cross sectional diagnostic study was conducted. Participants were three hundred and nineteen patients who had rule out acute appendicitis, at Department of Surgery, Detudom Royal Crown Princess Hospital from 2013 to 2017. Data of patients with appendicitis and used Alvarado score for diagnosis. Data were divided into 2 groups and group 1 no refer, group 2 refer form network according inclusion criteria. The validity was evaluated in relation to sensitivity, specificity, accuracy, false positive rate, false negative rate, positive predictive value, negative predictive value and likelihood ratio. Statistical analysis was done using statistical package for social science version16 statistical software (SPSS) and statistical significance was determined by a P < 0.05.
Results There were 319 patients with acute appendicitis and used Alvarado score diagnosis, 296 without disease from the confirmation from pathology. Group 1 (133 case) were female 58.65% mean age 36.40±19.90 years, mean waiting time for admit 11.5±6.9 hours, mean waiting time for treatment (operative) 18.0±7.7 hours, pathology report appendicitis 91.73% and rupture appendicitis 24.06%. Group 2 (186 case) were female 54.30% mean age 37.40±17.1 years, mean waiting time for admit 8.8±6.9 hours, mean waiting time for treatment (operative) 18.3±8.2 hours, pathology report appendicitis 93.01% and rupture appendicitis 32.37%. Regarding Alvarado score comparing with pathology, its validities were; Accuracy 50.34% Sensitivity 26.02% Specificity 67.63% PPV 32.35% NPV 52.34 Positive LR 0.80% Negative LR 1.09%
Conclusion The validity of the Alvarado score comparing with pathology yielded low sensitivity and moderate specificity. Therefore, in order to increase the accuracy of diagnosis for treatment, Alvarado score should be used in conjunction with other tools.
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