EVALUATION OF VALIDITY OF ALVARADO SCORING SYSTEM FOR DIAGNOSIS OF ACUTE APPENDICITIS

Objective: Appendicitis is part of the differential of an acute abdomen and can be difficult diagnosis to make. A number of clinical scores have been developed attempting to decrease the false- positive rates of appendectomies. In this study we evaluated validity of Alvarado score in patients with suspected appendicitis and compared its performance between men and women. Methodology: From May 2006 to December 2007, 152 adults who were operated for acute abdominal pain and diagnosis of acute appendicitis were evaluated. In each patient, signs, Symptoms, laboratory values and pathology reports were collected and evaluated. The sensitivity, specificity, positive and negative predictive values and receiver operator characteristic curves of each indicator were calculated in men and women. Results: In this study, we evaluated 152 patients (85 men, 67 women). In men, 71 patients had acute appendicitis. In women, 49 patients had acute appendicitis. In men the mean of total score was 7.3+/-1.18 in patients with acute appendicitis and 5.40.75 in non- appendicitis patients (p=0.001). In women, the mean of total score was 7.21.19 in patients with appendicitis and 6.31.37 in non-appendicitis patients (p=NS). The area under the curve was 0.91 for men and 0.71 for women Conclusion: Our study showed that Alvarado score is not accurate for determination of acute appendicitis in women. It also showed that in all patients with abdominal pain and right lower quadrant tenderness, operation should be performed without using the Alvarado score.