OBJECTIVE: Acute appendicitis is one of the commonest surgical emergency. There are different
scoring systems in use to diagnose the appendicitis. Aim of this study was to document the
diagnostic accuracy by application of Alvarado Scoring System in clinical practice for acute appendicitis.
DESIGN: Descriptive case series.
SETTING: Surgical Unit-II, Liaquat University Hospital Hyderabad, Sindh – Pakistan; from January
2003 to September 2004.
METHODS: All the patients with suspected appendicitis were admitted in the ward. A profroma
was designed and relevant findings were documented. These were observed regarding the increase
or decrease in severity of symptoms and hence the change in the initial score according
to Alvarado Scoring System was documented at the time of admission. Decision regarding surgical
intervention was made on the basis of change in the score.
RESULTS: A total of 227 patients with clinical features suggesting acute appendicitis was admitted
in the ward. Among them, 150 (66.07%) were males and 77 (33.92%) were females. Age
ranged from 10-62 years. Main symptoms at presentation included pain in right iliac fossa
67.8%, fever 66.9% and nausea and vomiting 49.7%. Thirty two patients were received with Alvarado
Score of 1-4 and three out of them required surgery. Thirty five patients were in the score
of 5, twenty three out of them required surgery. One hundred sixty patients were in the score of
6 and above, all of them required surgery. Out of 185 patients who underwent surgery, 178 patients
had appendicitis. The negative appendicectomy rate was 3.78%.
CONCLUSION: It is concluded that according to Alvarado the patients with score up to 4 probably
do not require surgery and among the patients with score up to 5, most of them need surgery
while the patients with the score of 6 and above will require surgery.
Appendicitis. Appendicectomy. Alvarado scoring system.