EVALUATION OF MODIFIED ALVARADO SCORE FOR FREQUENCY OF NEGATIVE APPENDICECTOMIES
Abstract
Background: Appendicitis being the commonest surgical emergency is primarily diagnosed clinicallybut posses diagnostic difficulty usually, especially to junior surgeons, demanding the need fortool/scoring system that can be easily applicable, accurate & reproducible in the diagnosis ofappendicitis, with low negative Appendicectomy rate. This study is designed to assess one such scoringsystem, i.e., Modified Alvarado Score. Methods: A total of 100 consecutive male and female patientswith age 10 year and above presenting with symptoms suggestive of acute appendicitis were includedin study, assessed according to eight variables of Modified Alvarado scoring system and wereaccordingly placed into 3 groups. Group–I patients having score 1–4 were discharged, Group-II patientshaving score 5–7 were observed while Group-III patients having score 8–10 were operated. Status ofappendix of operated patients was assessed histo-pathologically. Results: Out of 100 patients includedin study, 58 patients were operated on the basis of said scoring system. Of the operated patients 52(89.65%) had acute appendicitis, thus yielding a positive predictive value of 89.66% while negativeappendectomy rate of 10.34%. Frequency of negative appendicectomy was 7.69% (3/39) amongstmales and 15.79% (3/19) in females. Post-operative complication rate including wound infection,pelvic abscess, chest and urinary tract infection was 22.41% (13/58). Conclusion: Frequency of thenegative appendicectomies can be reduced through standardization of the diagnostic procedure, byapplying Modified Alvarado score in the diagnosis of suspected appendicitis cases as compared tosimple clinical assessment.Keywords: Appendicitis, Modified Alvarado Score, frequency, appendicectomyReferences
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