Evaluation of Alvarado score as an admission criterion in patients with suspected diagnosis of acute appendicitis
West African Journal of Medicine
Department of Surgery, Olabisi Onabanjo, University Teaching Hospital, Sagamu, Ogun State, Nigeria; P.O. Box 1303, Sagamu, Ogun State, Nigeria
Background: Patients with right iliac fossa pain present a diagnostic challenge to emergency room doctors when equivocal signs are present. Objective: To evaluate Alvarado score as an admission criterion in patients with suspected diagnosis of acute appendicitis. Methods: This was a prospective study of 100 consecutive patients who presented to the an emergency department with right iliac fossa pain and suspected diagnosis of acute appendicitis between January 2004 and December 2004. They were assessed using Alvarado score. Main outcome measures in relation to these scores were, patient's admission, patient's discharge, and whether patient had appendicitis or not. Results: The range of scores was 1-10. Seventy-four patients were admitted while 26 were discharged. Thirty-four patients with confirmed diagnosis of acute appendicitis had scores ranging from 5-10. No patient with score less than 5 had appendicitis. The sensitivity and negative predictive value reached 100% at scores below five, while specificity and positive predictive value reached 100% at the score of 10. Conclusion: The Alvarado score can be used as an objective criterion in selecting for admission patients with suspected diagnosis of acute appendicitis. Patients with scores of 4and below do not require admission since they turn out not to have acute appendicitis.
abdominal pain; acute appendicitis; adult; Alvarado score; article; clinical trial; controlled clinical trial; controlled study; correlation analysis; diagnostic accuracy; emergency ward; female; hospital admission; hospital discharge; human; major clinical study; male; outcome assessment; practice guideline; prediction; prospective study; scoring system; sensitivity and specificity; symptom; validation study; Abdomen, Acute; Adult; Appendicitis; Diagnosis, Differential; Emergency Service, Hospital; Female; Health Status Indicators; Humans; Male; Pelvic Pain; Prospective Studies; Severity of Illness Index