ALVARADO SCORING SYSTEM

Objectives: To evaluate the diagnostic accuracy (discrimination) andimplementation performance of Alvarado score. Study Design: Cross sectional study. Setting:Surgical Unit of Nishtar Hospital Multan under supervision of consultant Surgeons of Department.Period: 01 year from November 2016 to October 2017. Methodology: For quantitative variableslike age of patients Mean and SD was calculated, and frequency percentages were calculatedfor categorical data like gender. Negative appendectomy rate, positive predictive value,negative predictive value, sensitivity, specificity was calculated by using 2-2 contingency table.Results: Overall, 100% (n=300) patients enrolled in this study, both genders. Alvarado scoringat presentation, 15% (n=45) patients were categorized into Group I. 13% (n=39) patients wereincluded in Group II. While, 72% (n=216) were enrolled in Group III. Diagnostic test was positivein 223 patients. While, acute appendicitis was confirmed histo-pathologically in 160 patients.Gangrenous appendicitis observed in 3 patients. Chronic appendicitis, perforated appendicitis,appendicular abscess, no specific pathology, gangrenous intestine and salpingo-oophoritiswas observed as 31, 6, 9, 6, 3 and 5 respectively. There were 174 patients true positive, 49 werefalse positive, 59 were false negative and 18 were true negative. Sensitivity, specificity, negativepredictive value and negative predictive value were 74.68% 26.87%, 78.02% and 23.37%respectively. Conclusion: Alvarado scoring system is useful tool in diagnosis of appendicitisin pre-operative period which can be useful for surgeons at any level of health care. Accordingto our study observations Alvarado scoring system has better sensitivity 74.68% but specificity26.87% which shows that Alvarado scoring system is helpful in diagnosis of appendicitis but notmuch helpful in preventing negative laparotomies.