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Evaluation of Alvarado Score in Diagnosing Acute Appendicitis

Background: Using a reliable scoring system to diagnose acute appendicitis can help reduce the rate of unnecessary surgery and, henceforth, its complications. This cohort study aimed to evaluate Alvarado scoring system for diagnosing acute appendicitis in our health facility.

Methods: 100 patients of different age groups with clinical suspicion of acute appendicitis admitted in the General Surgical Ward, Karak Teaching Hospital in Karak, Jordan, from April, 2013 to December, 2014 were included in the study. All patients underwent surgery and were grouped according to the variables of Alvarado scoring system and then divided into two groups. Group I patients (score 7 or more), group II patients (scores 3-5, and 5-6). Diagnosis was confirmed by histopathologic examination. Reliability of scoring system was assessed by calculating negative appendectomy rate and positive predictive value.

Results: Out of total 100 patients, appendicitis was confirmed 80 patients, thus giving negative appendectomy rate of 20% (male 6%, female 16%). Perforation rate was 4%, positive predictive value was 90%, negative predictive value of 29%, sensitivity of 54%, specificity 75%, and diagnostic accuracy value of 58%.

Conclusion: Alvarado score is not sensitive tool for aiding diagnosis of acute appendicitis.


Awayshih MMA*,Yousef AJ and Nofal MN

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