Khalid Ahsan Malik, Rauf Sheikh.
Role of modified Alvarado score in acute appendicitis.
Pak J Surg Jan ;23(4):251-4.

Objective: To evaluate the efficacy of Modified Alvarado Score in Acute Appendicitis, and to correlation it with the operative and histopathological findings. Design & Duration: Observational, cross sectional study carried out in two phases, 2000-2001 at Nawahshah and 2002-2003 at Karachi. Setting: Nawabshah Medical College Hospital and Sindh Govt. Lyari General Hospital, Karachi. Patients: All patients admitted with the diagnosis of Acute Appendicitis during the study period. Methodology: After collecting the basic and clinical data, the patients were divided into three groups according to the Alvarado Score. Group-7 (Score 1-4) patients were put on conservative treatment and sent home, while Group III (Score 8-10) patients were operated after necessary preparations. Group-II (Score 5-7) cases were admitted, put on conservative treatment and, re-assessed and re-scored after few hours. Those settling down were discharged, while those deteriorting with increase in their Alvarado Score were operated. Modified Alvarado Score was then correlated with the operative and histopathological findings. Results: A total of 254 patients, 140 males and 114 females were included in the study. Majority (62.19%) of them were teenagers or in their twenties. Amongst them 174 patients, 110 of Group-Ill and 64 from Group-II, underwent appendicectomy. Out of these 20 (11.49%) cases had a normal appendix. Conclusion: Modified Alvarado Score is effective, cheap and easy to apply Hence it helps in improving the diagnosis in cases of Acme Appendicitis.

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