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  3. 10. Diagnostic Accuracy of Modified Alvarado Scoring System in Acute Appendicitis
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10. Diagnostic Accuracy of Modified Alvarado Scoring System in Acute Appendicitis

Altaf Hussain Ghumro1, Shahnawaz Abro2 and Abdul Hakeem Jamali1

ABSTRACT

Objective: Diagnostic accuracy of modified alvarado scoring system in acute appendicitis.

Study Design: Observational study

Place and Duration of Study: This study was conducted at the Department of Surgery, Liaquat and Peoples University of Medical and Health Sciences Hospital Hyderabad and Nawabshah from Jan. 2015 to Dec. 2016. Materials and Methods: This study was carried out on227 consecutive patients of suspected acute appendicitis in the Physical examination started from general look of the patient, pulse, blood pressure, temperature and respiratory rate. Systematic examination included examination of central nervous system, respiratory system, cardiovascular system and spines. Examination of abdomen including distention, various signs, exact location of tenderness, signs of peritoneal irritation like guarding, rigidity, rebound tenderness. In group 1 all patients treated conservatively and discharged to home with advice that if symptoms persist or condition detonates, visit emergency department immediately. In group 2 all patients kept under observation for 24 hours and reassessed at 6 hourly intervals. Those who improve on conservative treatment were discharged to home. Others in whom condition is not improved and the score increased then the later group patients were be submitted to group 3.

Results: Out of 227,150 (66.7%) were male and 77(33.92%) were female. Age ranged from 10-62 year with mean age was 23.4+7.7 years. 33(14.54%) patients had an alvarado score of 1-4. All of them were discharged after initial assessment and symptomatic treatment. 3 patients were readmitted due to increase in severity of symptoms and required surgical intervention. Operative findings confirmed acute appendicitis . 49 (21.59%) patients with an Alvarado score of 5 were admitted for observation and evaluation.37 patients required appendicectomy because of persistence of symptoms and 12 patients were discharged after 24 hours of observation . 61 (26.87%) patients had score of 6-7 and were admitted for observation and evaluation .All the patients had increased severity of symptoms and required surgical intervention 37% out of 227 patients were in the score range of 8-10, all of the underwent emergency surgery.

Conclusion: We conclude that modified Alvarado scoring system is a reliable, cheap, handy tool for diagnosis of acute appendicitis.

Key Words: Modified Alvarado scoring system, Acute Appendicitis, Diagnostic accuracy 

Citation of article: Ghumro AH, Abro S, Jamali AH. Diagnostic Accuracy of Modified Alvarado Scoring System In Acute Appendicitis. Med Forum 2017;28(5):41-45.