Correlation of Alvarado Score and Intra-operative Findings in patients presenting to a tertiary Center in Northwestern Nigeria
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 10
Abstract
BACKGROUND: Acute appendicitis is the most common abdominal emergency in both the developed and developing countries. This common surgical disease continues to remain a diagnostic problem. This study aims to evaluate the accuracy of the Alvarado score (AS) in the pre-operative diagnosis of acute appendicitis in our setting. METHODS: A prospective study conducted in Usmanu Danfodiyo University Teaching Hospital Sokoto over a three year period from July 2014 to June 2017. All consecutive patients operated during the study period with an initial clinical diagnosis of acute appendicitis were enrolled into the study. Alvarado scores were correlated with intra operative grades of appendicitis and histopathological findings. Sensitivity, specificity and accuracy of Alvarado Scores were calculated. RESULTS: One hundred and eleven patients were studied with a Male: Female (M:F) of 1.5:1 and mean age of 23.89±4.93years. Patients presenting within first 24hours had a perforation rate of 15% as against 41.2% for those that presented after 24hours. The sensitivities, specificities, positive and negative predictive values and diagnostic accuracies of AS were high at 90.3%, 83.3%, 96.6%, 62.5%, 89.2% respectively. Histological analysis showed a negative appendicectomy rate (NAR) of 16.2 %. Using a presumptive cut-off point of 7 for the Alvarado score the negative appendicectomy rate will reduce to 3.45%(P<0.001) . CONCLUSION: Alvarado Score has a high sensitivity, specificity, good diagnostic accuracy in patients of a predominantly Hausa-Fulani population. Routine use of Alvarado Score will significantly reduce the negative appendicectomy rate and reduce the rate of perforated appendicitis.
Authors and Affiliations
Dr Umar Muktar, Dr Stephen Agbo, Dr Abdulrazak Lawal, Dr Bello Usman
Keywords
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- EP ID EP402602
- DOI 10.9790/0853-1710098593.
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