medigraphic.com
ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2012, Number 3

<< Back Next >>

Cir Gen 2012; 34 (3)

Sensitivity and specificity of the Alvarado score in acute appendicitis at the High Specialty Regional Hospital of Veracruz

Hernández ML, Domínguez SDR

Language: Spanish
References: 18
Page: 179-184
PDF size: 139.41 Kb.


ABSTRACT

Objective: To determine the sensitivity and specificity of the Alvarado Score for the diagnosis of acute appendicitis at a high specialty regional hospital.
Setting: High specialty regional hospital in the city of Veracruz, Veracruz, Mexico.
Design: Cross-sectional, descriptive, ambispective observational study.
Statistical analysis: Binary logistic regression, chi square (χ2), odds ratio and ROC curves.
Results: The study included 384 (293 retrospective and 91 prospective) patients with a diagnosis of probable appendicitis and who were operated. Statistical analysis revealed that a better diagnostic accuracy is achieved with the Alvarado Score at a cut off ›5, with a sensitivity of 0.96%, specificity of 0.72, positive predictive value of 0.93% and negative predictive value of 0.82. The most frequently found criterion was pain in the right iliac fossa positive in 100% of patients with appendicitis subjected to surgery; however, the most specific criterion was the rebound with 94.3% of patients.
Conclusion: Criteria of the Alvarado Score are a useful tool for the diagnosis of acute appendicitis, it is applicable to all patients with acute abdominal pain suggestive of appendicitis as an admittance test, and to discard appendicular pathology in 5 points or less.


REFERENCES

  1. Paulson EK, Kalady MF, Pappas TN. Clinical practice. Suspected appendicitis. N Engl J Med 2003; 348: 236-242.

  2. Petroianu A. Diagnosis of acute appendicitis. Int J Surg 2012; 10: 115-119.

  3. Chong CF, Thien A, Mackie AJ, Tin AS, Tripathi S, Ahmad MA, et al. Comparison of RIPASA and Alvarado scores for the diagnosis of acute appendicitis. Singapore Med J 2011; 52: 340-345.

  4. Sanabria A, Domínguez LC, Bermúdez C, Serna A. Evaluation of diagnostic scales for appendicitis in patients with lower abdominal pain. Biomedica 2007; 27: 419-428.

  5. Limpawattanasiri C. Alvarado score for the acute appendicitis in a provincial hospital. J Med Assoc Thai 2011; 94: 441-449.

  6. Fente BG, Echem RC. Prospective evaluation of the Bengezi and Al-Fallouji modified Alvarado score for presumptive accurate diagnosis of acute appendicitis in University of Port Harcourt Teaching Hospital, Port Harcourt. Niger J Med 2009; 18: 398-401.

  7. Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med 1986; 15: 557-564.

  8. Kittisupamongkol W. Modified Alvarado score for acute appendicitis. Colorectal Dis 2009; 11: 788.

  9. Jang SO, Kim BS, Moon DJ. Application of Alvarado score in patients with suspected appendicitis. Korean J Gastroenterol 2008; 52: 27-31.

  10. Al-Mulhim AR, Al-Sultan AI. Modified Alvarado score for acute appendicitis in overweight patients. Saudi Med J 2008; 29: 1184-1187.

  11. Watters JM. The appendicitis inflammatory response score: a tool for the diagnosis of appendicitis that outperforms the Alvarado score. World J Surg 2008; 32: 1850.

  12. Velázquez MJD, Godinez RC, Vázquez GMA. Evaluación prospectiva de la Escala de Alvarado en el diagnóstico de apendicitis aguda. Cir Gen 2010; 32: 17-23.

  13. Ohle R, O’Reilly F, O’Brien KK, Fahey T, Dimitrov BD. The Alvarado score for predicting acute appendicitis: a systematic review. BMC Med 2011; 9: 139.

  14. Ting HW, Wu JT, Chan CL, Lin SL, Chen MH. Decision model for acute appendicitis treatment with decision tree technology--a modification of the Alvarado scoring system. J Chin Med Assoc 2010; 73: 401-406.

  15. Schneider C, Kharbanda A, Bachur R. Evaluating appendicitis scoring systems using a prospective pediatric cohort. Ann Emerg Med 2007; 49: 778-784.

  16. Horzić M, Salamon A, Kopljar M, Skupnjak M, Cupurdija K, Vanjak D. Analysis of scores in diagnosis of acute appendicitis in women. Coll Antropol 2005; 29: 133-138.

  17. Cağlayan K, Günerhan Y, Koç A, Uzun MA, Altınlı E, Köksal N. The role of computerized tomography in the diagnosis of acute appendicitis in patients with negative ultrasonography findings and a low Alvarado score. Ulus Travma Acil Cerrahi Derg 2010; 16: 445-448.

  18. Hansson J, Körner U, Khorrani-Manesh A, Solberg A, Lundholm K. Randomized clinical trial of antibiotic therapy versus appendicectomy asprimary treatment of acute appendicitis in unselected patients. Br J Surg 2009; 96: 473-481.




2020     |     www.medigraphic.com