Reliability of Diagnostic Performance of Alvarado Score and Ultrasound in Patients Suspected of Having Acute Appendicitis

Abstract

Objective: To evaluate diagnostic reliability of Alvarado score and ultrasound in patients who have suspicion of having acute appendicitis to get to a safe diagnosis without radiation exposure.
Methods: This is a retrospective study conducted on 100 patients who presented in emergency with presumed acute appendicitis at Fatima Memorial Hospital from 2016 to 2018. Study design is retrospective cross sectional.
Results: Using a cutoff value of ≥5.5 Alvarado score resulted in sensitivity of 76%, specificity of
93%, accuracy of 84%, PPV 94%, and NPV 73%. US showed a sensitivity of 66%, specificity of
97.6%, accuracy of 79%, PPV 97% and NPV 67%. There was no difference of accuracy between
the two modalities. Using both of these modalities can eliminate the use of CT scan.
Conclusions: Using Alvarado score as tool of exclusion and US as 1st investigation of choice, a case of acute appendicitis is not only diagnosed correctly but also radiation hazards of CT scan can be eliminated.