THE ROLE OF THE ALVARADO SCORING SYSTEM AND ULTRASONOGRAPHY IN THE DIAGNOSIS OF ACUTE APPENDICITIS

Conclusion:

TheAlvarado scoring system, based on symptoms, clinical signs and laboratory findings, and/or imaging studies, especially ultraso-nography, is helpful for diagnosing AA.

Results:

In 2008, 581 patients underwent appendectomy for presumed AA. Of these, 184 patients with both preoperative ultrasound and Alvara-do scores were evaluated. There were 95 male and 89 female patients with a median age of 24 years (range, 14-78). While 171 patients (93%) had AA, 13 patients (7%) did not. The sensitivity, specificity, positive predic-tive value, negative predictive value, and diagnostic value of the Alvarado score were 56%, 69%, 96%, 89%, and 56%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and diag-nostic value of ultrasonography were 52%, 38%, 92%, 94%, and 51%, respectively. The sensitivity, specificity, positive predictive value, nega-tive predictive value, and diagnostic value of both the Alvarado score and ultrasonography were 58%, 51%, 94%, 89%, and 58%, respectively.

Materials and Methods:

This study is a retrospective review of all pa-tients who underwent appendectomy for presumed AA in our clinic in 2008. The clinical diagnosis was established preoperatively based on clin-ical history, physical examination, laboratory tests, and radiologic find-ings. The patients’ Alvarado scores and ultrasonography findings were obtained from their medical records.

Purpose:

To determine the role and predictive value of the Alvarado scor-ing system and ultrasonography in the diagnosis of acute appendicitis (AA)