Diagnostic Accuracy of Alvarado Scoring for Diagnosis of Acute Appendicitis in Children

Abstract

Objective: To determine the diagnostic accuracy of Alvarado scoring for diagnosis of acute appendicitis in children. Study Design: This was a cross sectional validation study. Place of Study: Department of Pediatric Surgery, Services Hospital. Lahore. Duration: July 2017 to December 2017. Methodology: In this study the cases of both gender with age range 2 to 12 years were included. The diagnosis of acute appendicitis was made on the basis of fever, vomiting and right sided abdominal pain with raised total leucocyte count. True positive was labelled when there were inflammatory cells found on histopathology. The detailed Alvarado scoring was used and to label the cut off value of 6 was used. Results: In the present study there were total 386 cases with mean age of 7.45±2.45 years. There were 208 males and 178 females. Alvarado score in cases who underwent appendectomy was 5 and maximum 8 with mean of 6.92 ± 0.898. The mean Alvarado score was 5.76±2.77. Alvarado score 6 or above was seen in 286 cases while 280 cases were confirmed as acute appendicitis on histopathology. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of Alvarado score 6 or more was seen in 89.29%, 66.04%, 87.41%, 70% and 82.90% respectively with a significant p value of 0.001. Conclusion: Acute appendicitis is an acute emergency and Alvarado score 6 or above has shown significant better diagnostic accuracy in such cases.