EVALUATION OF PREOPERATIVE DIAGNOSTIC ACCURACY OF MODIFIED ALVARADO SCORING SYSTEM IN ACUTE APPENDICITIS

BACKGROUND The Modified Alvarado Scoring System (MASS) has been shown to be easy, simple and cheap diagnostic tool for supporting the diagnosis of acute appendicitis. However, its application and usefulness has not been evaluated in the current study settings in the diagnosis of acute appendicitis. Hence, this study was conducted. Objectives- 1. To evaluate the specificity and sensitivity of Modified Alvarado Scoring System in the diagnosis of Acute Appendicitis. 2. To assess the rate of negative laparotomies. MATERIALS AND METHODS A cross-sectional study was conducted for a period of 18 months among 107 patients presenting at the surgery OPD, Sri Siddhartha Medical College Hospital and Research Centre, Tumkur, with complaints of pain in right iliac fossa with suspected features of acute appendicitis. The informed consent was taken. After considering the inclusion and exclusion criteriae, study subjects were categorised based on modified Alvarado scoring system. The subjects with >= 7 were made to undergo appendicectomy and those with score < 7 were re-scored after conservative management. The pre-operative diagnostic accuracy was evaluated. RESULTS The mean age of the study participants was 26.54 +/- 10.46 yrs. and majority were males. Most frequent complaint was nausea and/or vomiting. The sensitivity, specificity, positive (PPV) and negative predictive values (NPV) and diagnostic accuracy were 97.4%, 79.3%, 92.7%, 92.0%, 92.5% respectively. Negative appendicectomy rate was 7.3%. CONCLUSION MASS score of >= 7 is found to be having high sensitivity, PPV, NPV and good specificity, hence can be used as diagnostic indicator of acute appendicitis in the low resource setting.