doiSerbia

Evaluation of the Alvarado score in the diagnosis of acute appendicitis

Subotić A.M. (Emergency center, Clinical centre of Serbia, Belgrade)
Šijački A.D. (Emergency center, Clinical centre of Serbia, Belgrade)
Dugalić V.D. (First Surgical Clinic, Institute for Digestive Diseases, Clinical centre of Serbia, Belgrade)
Antić A.A. (First Surgical Clinic, Institute for Digestive Diseases, Clinical centre of Serbia, Belgrade)
Vuković G.M.
Vukojević V.S.
Glišić T.M.
Galun D. (First Surgical Clinic, Institute for Digestive Diseases, Clinical centre of Serbia, Belgrade)
Petrović M.N. (First Surgical Clinic, Institute for Digestive Diseases, Clinical centre of Serbia, Belgrade)

This study has been performed in the Emergency center, Clinical centre of Serbia, during the period 01.03.2007-01.09.2007. We performed this study on 57 patients with diagnosis suspected for acute appendicitis (ages 16-70). Parameters that make the Alvarado score are the following: migration of pain, anorexia, nausea or vomiting, right lower abdominal quadrant tenderness, rebound tenderness in right iliac fossa, elevated temperature, leukocytosis, shift to the left of neutrophils. The aim of the work is to evaluate the Alvarado scoring system in diagnosis of the acute appendicitis. With all the patients Alvarado score has been determinate preoperatively, and diagnosis was confirmed by intraoperative finding and histopatological examination of the removed appendix. All the patients with score 7 or more were surgically managed. Specificity (positive predictive value) was 92,59 % in males and 76,67 % in females. The negative appendectomy rate was 7,41 % with the males and 23,33 % with the females. The values of the Alvarado score are significantly higher in the patients with acute appendicitis, compared with the patients of the other diseases. With the application of the Alvarado scoring system we can decrease postoperative morbidity and mortality.

Keywords: acute appendicitis, peritonitis, Alvarado score, postoperative complications