Comparison of Alvarado Score and Ultrasound Diagnostic Efficacy in the Case of Acute Appendicitis
Iranian Journal of Emergency Medicine,
Vol. 9 No. 1 (2022),
16 March 2022
,
Page e11
https://doi.org/10.22037/ijem.v9i1.36090
Abstract
Introduction: Acute appendicitis is one of the most common causes of abdominal pain and is an emergency surgical procedure. Appropriate and early diagnosis of appendicitis followed by immidiate and proper action can significantly reduce its mortality rate and disability. Due to the high prevalence of negative appendectomy cases, the aim of present study was the comparison of Alvarado score and ultrasound diagnostic efficacy in the case of acute appendicitis
Methods: This cross-sectional study was performed on patients referred to the emergency department of Hamadan Besat hospital during 1397-1397 who underwent appendectomy with the final diagnosis of acute appendicitis. The data of this study were collected by file reading method and sampling was done using census method. Extracted data from patients' records included signs and symptoms of clinical examination, laboratory findings, ultrasound results, and pathological findings after appendectomy. Alvarado score was calculated based on clinical and laboratory findings. The final result of Alvarado score and sonography was compared with the result of pathology report as the gold standard and the indices of sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated.
Results: Out of 100 patients studied, 51 were female and 49 were male. The mean age of patients was 24.24 ± 13.99 years. Compared with the pathology report, sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Alvarado score in diagnosing acute appendicitis were 92.9%, 75.0%, 89.8%, 33.3% and 84.5%, respectively and for ultrasound were 0.60%, 50.5%, 89.5%, 15.0% and 58.8%, respectively.
Conclusion: The Alvarado score is very helpful in the clinical decisions of acute appendicitis in suspected patients and its diagnostic efficacy is higher than ultrasound. However, with the help of both diagnostic methods (Alvarado score and ultrasound), diagnostic accuracy may be increased.
- Acute appendicitis
- Alvarado criteria
- ultrasound
- appendectomy
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References
Newton E, Mandavia S. Surgical complications of selected gastrointestinal emergencies: pitfalls in management of the acute abdomen. Emergency medicine clinics of North America. 2003;21(4):873-907, viii.
Douglas CD, Macpherson NE, Davidson PM, Gani JS. Randomised controlled trial of ultrasonography in diagnosis of acute appendicitis, incorporating the Alvarado score. Bmj. 2000;321(7266):919.
Davoodabadi A, Rasoolinejad SAA, Jamali MR. Prevalence of acute appendicitis in different lunar months in Kashan 1420-1418 Kowsar medical journal. 2003;8(2):120-18.
Rosengren D, Brown AF, Chu K. Radiological imaging to improve the emergency department diagnosis of acute appendicitis. Emergency Medicine. 2004;16(5‐6):410-6.
Mohebbi H. A., Panahi F., Moussavi Naieni S. M., Kabir A. Comparison of diagnostic accuracy of acute appendicitis in active duty soldiers with control group. Journal of Military Medicine. 2004;6(1):7-12.
Farrokh Tehrani D, Hashemi j, Layegh P, ghafour poor M, ravanshad Y. Evaluation of CT scan in patients suspicious for acute appendicitis with negative or equivocal sonographic findings. medical journal of mashhad university of medical sciences. 2015;58(8):466-72.
Aslanabadi S, Mofidi M, Yosef Nezhad O, Maghsoodi H. Diagnostic Value of C-Reactive Protein for Detection of Acute Appendicitis in Adults. Razi Journal of Medical Sciences. 2009;16:0-.
Gulzar S, Umar S, Dar G, Rasheed R. Acute appendicitis-importance of clinical examination in making a confident diagnosis. Pakistan Journal of Medical Sciences. 2005:125-32.
Memon AA, Vohra LM, Khaliq T, Lehri A. Diagnostic accuracy of Alvarado score in the diagnosis of acute appendicitis. Pak J Med Sci. 2009;25(1):118-21.
Abou-Nukta F, Bakhos C, Arroyo K, Koo Y, Martin J, Reinhold R, et al. Effects of delaying appendectomy for acute appendicitis for 12 to 24 hours. Archives of surgery. 2006;141(5):504-7.
Khorshidi HR, Mani Kashani K, Azimian MH, Khalaj AR, Jafari M. Evaluation of Quantitative Measurement of CRP in Diagnosis of Acute Appendicitis. Avicenna Journal of Clinical Medicine. 2006;13(2):60-3.
Chan I, Bicknell SG, Graham M. Utility and diagnostic accuracy of sonography in detecting appendicitis in a community hospital. American Journal of Roentgenology. 2005;184(6):1809-12.
Motie MR, Mousavi M, Behnampour N, Mortazavy B, Kalany MR. Accuracy of ultrasonography in diagnosis of acute appendicitis. Journal of Gorgan University of Medical Sciences. 2009;11(4):70-5.
Kaiser S, Jorulf H, Söderman E, Frenckner B. Impact of radiologic imaging on the surgical decision-making process in suspected appendicitis in children1. Academic radiology. 2004;11(9):971-9.
Memon ZA, Irfan S, Fatima K, Iqbal MS, Sami W. Acute appendicitis: Diagnostic accuracy of Alvarado scoring system. Asian Journal of Surgery. 2013;36(4):144-9.
Kessler N, Cyteval C, Gallix Bt, Lesnik A, Blayac P-M, Pujol J, et al. Appendicitis: evaluation of sensitivity, specificity, and predictive values of US, Doppler US, and laboratory findings. Radiology. 2004;230(2):472-8.
Ozkan S, Duman A, Durukan P, Yildirim A, Ozbakan O. The accuracy rate of Alvarado score, ultrasonography, and computerized tomography scan in the diagnosis of acute appendicitis in our center. Nigerian journal of clinical practice. 2014;17(4):413-8.
Javadi M, Moradi Y, Behnoud S, Seifpanahisha’bani H, Rostampour F. Evaluation of the Sensitivity and Specificity C- reactive protein, and leukocyte count in the diagnosis of acute appendicitis and its types. Pajouhan Scientific Journal. 2013;11(2):9-14.
M L, L G, F K, A S, AR S. Sonography versus the Alvarado Scoring System for the diagnosis of acute appendicitis. Tehran University Medical Journal. 2008;66(6):408-12.
Kasabe PS, Relekar MR. Comparison of Alvarado score and ultrasonography in diagnosis of acute appendicitis. International Journal of Surgery. 2020;4(2):109-13.
Kumar PS, Karthik P. Determination of sensitivity and specificity of modified alvarado score and ultrasonography in patients with acute appendicitis. International Journal of Scientific Research. 2020;8(12).
Nikandam Modabber B, Pouya M. Investigation Study the Specificity and Sensitivity of Ripasa and Alvarado Score in the Diagnosis of Acute Appendicitis in Patients Referred to Shaheed Rajaee Hospital [2016-2018]. Journal of North Khorasan University of Medical Sciences. 2019;11(2):31-5.
Barman M, Das K, Mukherjee K. A Study on Comparision of Diagnostic Efficiency between Modified Alvarado Score and Graded Compression Ultrasonography in the Case of Acute Appendicitis. International Journal of Current Research and Review. 2018;10(9):22-6.
Dsouza C, Martis J, Vaidyanathan V. Diagnostic efficacy of modified alvarado score over graded compression ultrasonography. Nitte University J Health Science. 2013;3(3).
Nasiri S, Mohebbi F, Sodagari N, Hedayat A. Diagnostic values of ultrasound and the Modified Alvarado Scoring System in acute appendicitis. International journal of emergency medicine. 2012;5(1):26.
Kurane SB, Sangolli M, Gogate A. A one year prospective study to compare and evaluate diagnostic accuracy of modified Alvarado score and ultrasonography in acute appendicitis, in adults. Indian journal of surgery. 2008;70(3):125.
Hooshmand B, Shokouh-Saremi A, Noferesti A, Yaghobi MA, Elahifar A. Diagnostic accuracy of Alvarado score in the diagnosis of acute appendicitis. Zahedan Journal of Research in Medical Sciences. 2012;13(8).
Mohammadi A, Khodabakhsh F. Sensitivity and specificity of ultrasonography in diagnosis of acute appendicitis. 2009.
Stephens P, Mazzucco J. Comparison of ultrasound and the Alvarado score for the diagnosis of acute appendicitis. Connecticut medicine. 1999;63(3):137-40.
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