Evaluation of the diagnostic accuracy of Modified Alvarado scoring system in Comparison to Histopathological results in Acute appendicitis.

  • Nirmala Mysore Jayakumar PES Institute of Medical Sciences, Andhra Pradesh(India)
  • Shahanuma Shaik PES Institute of Medical Sciences, Andhra Pradesh(India)
  • Rajendra Naidu PES Institute of Medical Sciences, Andhra Pradesh(India)
Keywords: Acute appendicitis, Modified Alvarado scoring system, Appendecectomy.


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. Conclusions: The study concludes that the Modified Alvarado scoring system is more sensitive in diagnosing acute appendicitis with reference to the histopathological findings.DOI: 10.21276/APALM.1642 


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