Publication:

A three year prospective study-suspected acute appendicitis: diagnostic accuracy of modified Alvarado score versus ultrasonography in adults

Background To evaluate and compare diagnostic accuracy of modified Alvarado score and ultrasonography in co-relation to histopathology report for diagnosis of acute appendicitis.

Methods A prospective study of the patients who underwent appendectomy for suspected acute appendicitis at IIMS and R Medical College and Noor Hospital Warudi, Badnapur, Dist. Jalna (Maharashtra). The clinical (radiological) and ultrasonography data of 760 patients with suspected appendicitis was collected between March 2014 to Feb. 2017. These patients were evaluated by modified Alvarado score and ultrasonographically, which was corrected with histopathological finding.

Results Out of 760 patients 69.34% had acute appendicitis 63.81% had modified Alvarado score≥7 and 58.28% patients were ultrasonographically positive. In present study modified Alvarado score has sensitivity of 89.37% specificity 93.99% positive predictive value 97.11%, negative predictive value 79.64%, diagnostic accuracy of 81.32%.

Conclusions Modified Alvarado score can be used effectively in clinical decision making. When compare with ultrasonography neither one is advantageous. However, additional information provided by ultrasonography improves diagnostic accuracy.