MODIFIED ALVARADO SCORING AS A DIAGNOSTIC TOOL IN ACUTE APPENDICITIS- A PROSPECTIVE STUDY
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 14
Abstract
BACKGROUND Acute Appendicitis commonest community-acquired intra-abdominal infections. Acute appendicitis and its associated complications are significant source of morbidity and sometimes mortality. The Modified Alvarado Scoring System (MASS) has been reported to be a cheap and quick diagnostic tool in patients with acute appendicitis. Diagnostic accuracy have been observed if the scores were applied to various populations and clinical settings. The purpose of this study was to evaluate the diagnostic value of Modified Alvarado Scoring System in patients with acute appendicitis in our setting. The aim of the study is to evaluate the efficacy of the modified Alvarado score as a diagnostic tool in Acute Appendicitis, as the diagnosis of appendicitis depends on the onset of symptoms and the subjective interpretation of the physical examination. MATERIALS AND METHODS This was a prospective study carried out in Pondicherry Institute of Medical Science during the period of November 2013 to May 2015. This study was done on 50 patients diagnosed with Acute Appendicitis and admitted in General Surgery. RESULTS In this study, there were a total of 50 patients who were taken up for surgery based on clinical and radiological diagnosis. Our study demonstrates that modified Alvarado score applied to all adult patients of acute appendicitis in adults with a sensitivity of 60% and a specificity of 40% only. Showing it wasn’t efficient in diagnosing acute appendicitis. The positive predictive value shown by our study was 80% which is marginally lower than that explained in literature which reports 87.5%. Negative appendicectomy rate in this study is 12%. CONCLUSION Alvarado score is a non-invasive, safe diagnostic procedure, which is simple, fast reliable and repeatable; it can be used in all conditions, without expensive and complicated supportive diagnostic methods. Alvarado score increases the diagnostic certainty of clinical examination in diagnosis of acute appendicitis. The implementation of Modified Alvarado Score though simple, effective and reliable can only be used as a guide in the diagnosis of appendicitis and not as a definite modality to diagnose appendicitis. However, additional investigations may be required to confirm the diagnosis in case of atypical presentation.
Authors and Affiliations
Arun Kumar V. K, Ashwin Chand, Achu Jacob Philip, Sidharth Sabu Cherian
Keywords
Related Articles
- EP ID EP214172
- DOI 10.18410/jebmh/2017/151
- Views 105
- Downloads 0
A PROSPECTIVE OBSERVATIONAL STUDY ON POISONING CASES IN A TERTIARY CARE HOSPITAL IN TAMILNADU
BACKGROUND High incidence of encounters with agricultural poisons, and lack of data from Indian scenario, necessitate studies in this regard. Our study aims at investigating the pattern of acute poisoning cases in a tert...
A STUDY ON COMPLICATIONS OF THYROID SURGERY AT GOVERNMENT GENERAL HOSPITAL KAKINADA
BACKGROUND Thyroid disorders are one of the most common causes of metabolic disturbances with surgery forming the main stay of treatment of thyroid swellings. Thyroid surgery in the hands of experienced surgeons is curre...
A CLINICAL AND SURGICAL STUDY OF INCISIONAL HERNIAS
BACKGROUND Incisions through the abdominal wall are based on anatomical principles. The intra-abdominal pressure is considerable and the surgeon aims at leaving the abdominal wall as strong as possible after operation, o...
CALVARIAL TUMOURS- A TEN-YEAR STUDY OF SEVENTY PATIENTS
BACKGROUND The aim of this study was to find out epidemiologic and clinical features of benign calvarial lesions in Neurosurgery Department at SKIMS, Srinagar, Kashmir. The aim of this article is also to describe imaging...
TWO CASES OF TYPE II RESPIRATORY FAILURE IN COPD TREATED IN KATURI MEDICAL COLLEGE HOSPITAL, GUNTUR AND AN OVERVIEW OF TREATMENT OF ACUTE EXACERBATION AND RESPIRATORY FAILURE
Treatment of Type II Respiratory Failure in a COPD patient is a difficult task for the ICU and Pulmonary physician. Multi factorial and multi-disciplinary approach is required. Our experience of two cases treated recentl...