Diagnostic accuracy of Alvarado score in the diagnosis of acute appendicitis


avatar Behrooz Hooshmand 1 , avatar Afshin Shokouh-Saremi 2 , avatar Alireza Noferesti 2 , avatar Mohammad Ali Yaghobi 3 , * , avatar Armin Elahifar 3

Assistant Professor of Surgery, Islamic Azad University, Mashhad Branch, Mashhad, Iran.
General Physician, Mashhad, Iran.
Resident of Internal Medicine, Mashhad University of Medical Siences, Mashhad, Iran.

how to cite: Hooshmand B, Shokouh-Saremi A, Noferesti A, Yaghobi M A, Elahifar A. Diagnostic accuracy of Alvarado score in the diagnosis of acute appendicitis. Zahedan J Res Med Sci. 2012;13(8):e93767.


Background: Acute appendicitis is one of the commonest surgical emergencies. There are different scoring systems in use to diagnose the appendicitis. The aim of this study was to assess the diagnostic accuracy of Alvarado scoring system in clinical practice for acute appendicitis.
Materials and Method: This medical diagnostic-test study was performed from January 2009 till September 2010 in surgery clinic of Farabi hospital, Mashhad. For all patients, Alvarado score has been determinate preoperatively and intraoperative finding and histopatological examination of the removed appendix confirmed diagnosis.
Results: The study was conducted among 150 patients (63% male, 37% female). Specificity was 68 %, whereas sensitivity was 74.8%. The negative appendectomy rate was 5.7% with score 7 or more Alvarado score. The positive predictive value was 98.1%. The accuracy rate was 74%. The cut-off score was 7.
Conclusions: In the diagnosis of acute appendicitis Alvarado score has a high diagnostic value (74%). Alvarado score increases the diagnostic certainty of clinical examination in diagnosis of acute appendicitis.


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