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Abstract

ACCURACY OF ALVARADO SCORE IN THE DIAGNOSIS OF ACUTE APPENDICITIS

Dr. Santhosh Laxman1, Dr. Pramod Sangolgi*, Dr. Arun Bhavikatti and Dr. Arun Uttam

ABSTRACT

Aims and Objective: 1. To determine the accuracy of ultrasound in the diagnosis of acute appendicitis. 2. To compare the ultrasound diagnosis with intra operative diagnosis. Materials and Methods: Study was conducted in tertiary care hospital of north Karnataka. Duration of study was three years from January 2014 to December 2017. Hundred cases of clinically diagnosed acute appendicitis patients were studied and compared with data from literature. 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) and 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 53cases out of 54 patients, while at scores <7 appendicitis was confirmed in 38 cases out of 46 patients. The sensitivity was 58.2%, specificity was 88.9% and positive predictive value was 98.1%. Conclusion: The sensitivity was 58.2%, specificity was 88.9% and positive predictive value was 98.1%. Alvarado score being a less Sensitive test should not be used as an initial screening test in the diagnosis of acute appendicitis. Alvarado score being more specific test can be used as a definitive test in the diagnosis of acute appendicitis.

Keywords: Acute Appendicitis, Alvarado score, Accuracy.


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