Evaluation of the diagnostic accuracy of Modified Alvarado scoring system in Comparison to Histopathological results in Acute appendicitis.
Keywords:
Acute appendicitis, Modified Alvarado scoring system, Appendecectomy.Abstract
Background: Acute appendicitis even today remains the commonest cause of acute abdomen needing surgical intervention. In developing countries the clinical diagnosis still poses a challenge to the surgeon and advanced radiological investigations are not cost effective while histopathological diagnosis remains the gold standard. The Modified Alvarado score augments the accuracy of diagnosis of appendicitis thus reducing the rate of negative appendicectomy.
Methods: Patients admitted  with clinical findings suggestive of Acute appendicitis were evaluated by applying  Modified Alvarado scoring system.Those patients with  Alvarado scores above 5  were  subjected to appendicectomy.The Modified Alvarado score  was correlated with that of histopathologial features of appendicectomy specimens.
Results: The histopathological features of appendicitis was seen in 87.8% of the cases whose scores were more than 7 while negative appendicitis was seen in  38.1% whose  scores were between 5-7.The sensitivity, specificity, positive predictive value and negative predictive value of Alvarado scores in our study were 87.80%, 38.01%, 73.50% and 61.50% respectively.Â
Conclusions: The study concludes that the Modified Alvarado scoring system is more sensitive in diagnosing acute appendicitis with reference to the histopathological findings.
DOI:Â 10.21276/APALM.1642
Â
References
2. Jagdish BK, Mukesh DK, Palekar HD, Upendra P. Utility of Alvarado score in diagnostic acute appendicitis in children: A cross sectional study.National Journal of Medical Research,2014;4:125-127.
3. Rajashekar J, Uday M, Naveen N. Modified Alvarado score and its application in the diagnosis of Acute Appendicitis.International Journal of Contemporary Medical Research,2016;3:1398-1400.
4. Kodliwadmath HB, Bhaskaran A, Prasad CSBR, Basavaraj M, Ambikavathy M, Vasantkumar G. Evaluation of Modified Alvarado score in the diagnosis of Acute Appendicitis and its correlation with Ultrasonography and histopathology.J Clin Biomed Sci,2011;1(4):149-157.
5. Alvarado A. A practical score for the early diagnosis of acute appendicitis.Ann Emerg Med, 1986;15(5): 557-564.
6. Jones K, Penna AA, Dunn EL, Nadalo L, Mangram AJ. Are negative appendicectomies still acceptable? Am J Surg,2004;188(6):748-754.
7. Ana J, Syed AS, Muhammad S, Muhammad Z, Umbreen R, Yasir H. Alvarado scoring system in prediction of Acute appendicitis. Journal of the College of Physicians and Surgeons Pakistan, 2011; 21(12):753-755.
8. O`Connell PR. The vermiform appendix. In, Williams NS, Bulstrode CJ, O`Connell PR (ed). Bailey & Love`s Short Practice of Surgery,26th edition.Boca Raton, FL, CRC press,2013;1199-1214.
9. Ercan I, Elif H, Sibel A, Figen P,Tan C, Ahmet NJ, Ersan A. Efficiency of unenhanced MRI in the diagnosis of acute appendicitis: Comparison with Alvarado scoring system and histopathological results.European Journal of Radiology, 2011;80:253-258.
10. Riti TKS, Aniruna D.A Retrospective study of histopathological features of Appendecectomy specimens- What all can expect? Journal of Medical Sciences and Health,2016;2:6-12.
11. Nanjundaiah N, Ashfaque M, Venkatesh S, Kalpana A, Priya SA. A Comparative study of RIPASA score and Alvarado score in the diagnosis of acute appendicitis.Journal of Clinical and Diagnostic Research,2014;8(11):3-5.
12. Nishikant G, Sajid M, Ravikumar C, Sachin DM. Determination of Sensitivity and Specificity of Modified Alvarado score and Ultrasonography in patients with Acute appendicitis. Journal of Krishna Institute of Medical Sciences University,2015;4(2):89-99.
13.Dey S, Pradip KM, Anil KB, Bikram K, Kincha LB, Varun KS. Alvarado scoring in Acute appendicitis- A Clinico Pathological Correlation. Indian J Surg,2010;72(4):290-293.
14. Ratnadeep SS, Girish LJ, Milind SC. Correlation of Alvarado score for acute appendicitis with pathological appendicitis, Int Surg J.2016;3(3):1451-1455.
15. Malhotra MK, Sharma RG, Goyal S, Panwar U, Singal KK, Dwivedi S. Is diagnostic accuracy of Alvarado scoring feasible in acute surgery for management of acute appendicitis? Bangladesh Journal of Medical Sciences,2016;15(2):166-171.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2018 Nirmala Mysore Jayakumar, Shahanuma Shaik, Rajendra Naidu
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).