Original Research Article
Year: 2017 | Month: July | Volume: 7 | Issue: 7 | Pages: 38-44
Modified Alvarado Scoring System as a Diagnostic Tool in a Central Indian Rural Hospital
Anurag1, Siddharth Rao2, Dilip Gupta3, Bhupendra Mehra3
1Resident Surgery, 2Associate Professor, 3Professor,
Department of Surgery, MGIMS, Sewagram, Wardha
Corresponding Author: Anurag
ABSTRACT
Acute appendicitis is the most common cause of acute abdomen which compels the patient to seek medical attention and appendectomy is most commonly performed operation in acute abdomen. Lifetime risk of acute appendicitis in general population is 7%. Various scoring systems were developed over time to aid the clinical suspicion of acute appendicitis.
Aim: The purpose of this study was to compare the Modified Alvarado scores of patients attending a rural hospital and ultrasonographic findings with their operative findings.
Materials and Methods: A prospective study was conducted in department of surgery of 1000 bedded rural hospital of central India. Patients presented with abdominal pain suggestive of acute appendicitis and were subsequently operated from November 2014 to August 2016 were included. Both male and female patients were enrolled in the study. Modified Alvarado score was assigned to all and ultrasonography was done, and the results were compared with operative and histopathological findings.
Results: 103 patients were included on the basis of inclusion and exclusion criteria. Out of 103 patients included 93 were diagnosed as features of appendicitis on the basis of histopathological study. Out of these 103 patients included in study the ultrasonographic findings were positive in 92 patients and out of these 92 patients, 90 patients were found to have features of appendicitis on histopathology. Out of 95 patients having Modified Alvarado score more than 7, 91 were found to have acute appendicitis. Sensitivity of Modified Alvarado score in this study was 97.8%, the specificity 60%, positive predictive value 95.8%, negative predictive value 75%. Negative appendectomy rate in this study was 9.7%.
Conclusion: This scoring system is a simple, efficient, reliable and practicable diagnostic modality to increase the accuracy in diagnosis of acute appendicitis and thus to minimize unnecessary appendectomy.
Key words: Modified Alvarado score, acute appendicitis, appendectomy.