Diagnostic accuracy of alvarado score in the diagnosis of acute appendicitis

Objective: To determine the diagnostic accuracy of Alvarado score in the diagnosis of acute appendicitis. Methodology: Study was conducted in Surgical Ward 5, Pakistan Institute of Medical Sciences Islamabad. Duration of study was Six month from December 2006 to June 2007. Hundred consecutive patients which presented to our surgical team with acute appendicitis were assessed prospectively using Alvarado score. They were given specific scores according to the variable and divided into two groups, group one (score ≥7) group two (score <7). All patients were operated irrespective of score, if clinical diagnosis of acute appendicitis was made. Postoperatively, diagnosis was confirmed by histopathology report. Validity of scoring system was assessed by calculating sensitivity, specificity and positive predictive value. Results: Total 100 patients were included in the study, which included 65 males and 35 females, at score ≥7, appendicitis was confirmed in 53/54 patients, while at scores <7 appendicitis was confirmed in 38/46 patients. The sensitivity was 58.2%, specificity was 88.9% and positive predictive value was 98.1%. Conclusion: Clinical experience remains of major importance in diagnosing acute appendicitis. The Alvarado score is a simple, easy scoring system at both end of scale.