Is Modified Alvarado Score More Accurate in the Diagnosis of Acute Appendicitis?

Abstract

Introduction: Acute appendicitis is recognized as the most prevalent abdominal surgical emergency treated by general surgeons. Diagnosing acute appendicitis can be challenging, particularly in the early career of doctors facing several similar conditions. Multiple scoring systems have been established to aid in diagnosing acute appendicitis. These tools help reduce unnecessary appendectomies and maintain a decrease in morbidity and mortality rates. The Alvarado scoring system is based on patient history, physical examinations, and specific laboratory tests, making it easy to implement. Objective: To assess the accuracy of the Modified Alvarado Score (MAS) in diagnosing acute appendicitis, using histopathology as the gold standard. Materials and Methods: A Cross-Sectional Study was conducted from 20-04-2020 to 20-10-2020. About 116 patients from the Department of Surgery at Khyber Teaching Hospital, Peshawar, with a suspicion of a diagnosis of acute appendicitis, were included. Patient sampling was consecutive and subjected to MAS, and histopathology was acquired postoperatively to confirm acute appendicitis. Results: The mean age of the patients was 30.2 + 6.9 years. Males were 54.3%, and females 45.7%. In our study on MAS, we found that acute appendicitis was diagnosed in 60.3% of patients. Following surgical intervention, histopathological analysis confirmed the acute appendicitis in 47.4% of patients. The sensitivity of MAS was determined to be 90.9%, while the specificity was 67.2%. Additionally, the positive predictive value of MAS was 71.4%, and the negative predictive value was 89.1%. Conclusion: The Modified Alvarado Score is clinically useful in adults, with considerably high sensitivity and specificity in diagnosing acute appendicitis.