Publication:

Evaluation of Alvarado scoring system (MANTRELS scoring) as a diagnostic aid in preoperative diagnosis of acute appendicitis at Nalanda Medical College and Hospital, Patna

Background Acute appendicitis is one of the commonest surgical emergencies. The rate of negative appendicectomy has been reported to be between 20-30%. The aim of this study is to evaluate the efficacy of Alvarado scoring system in cutting down the rate of negative appendicectomy without increasing morbidity and mortality.

Methods A study of 100 patients presenting with pain abdomen and diagnosed provisionally as acute appendicitis, was undertaken. Depending on individual presentation, a score was calculated for each case, based on Alvarado scoring system. Operative and conservative intervention was undertaken in patients with scores between 5 and 10 and <5 respectively. The results of Alvarado scoring system, on table operative findings and HPE, were reviewed.

Results A total of 94 patients with score of 7-10 and 5-6 were operated. Among males with score of 7-10, 33 patients were operated and 31 were found to have inflamed appendix. Among females with score of 7-10, 33 patients were operated and 28 were found to have inflamed appendix. The sensitivity of Alvarado scoring system in males with score of 7-10 was found to be 81.57% and among females with score of 7-10 was found to be 75.67%.

Conclusions The Alvarado scoring system is a fast, simple, reliable, non-invasive, repeatable and safe diagnostic modality without extra expense and complications.