Abdul Samad, Basant Kumar, Tariq Wahab Khanzada, Devanand Lohana.
Appropriate cut-off value of Alvarado scores for patients undergoing appendectomy at Isra University Hospital, Hyderabad.
Isra Med J Jan ;1(2):36-9.

OBJECTIVE: To determine the frequencies as well as the appropriate cut-off value of Alvarado scores in patients undergoing appendectomy at Isra University Hospital, Hyderabad-Sindh, Pakistan. DESIGN: A descriptive study. PLACE AND DURATION: Isra University Hospital, Hyderabad, from September 2007 to September 2008. PATIENTS AND METHODS: One hundred consecutive patients fulfilling the selection criteria during the above mentioned period were included in this study. After the detailed history, clinical examination and relevant investigations, the Alvarado score was calculated for each patient. After appendectomy, the relationship of operative and histopathological findings with Alvarado score as well as cut-off points for the decision of appendectomy was analyzed. RESULTS: The majority of patients were between the ages of 15 to 30 years with male to female ratio of 2.2:1. The commonest operative finding was acutely inflammed appendix followed by perforated appendix, gangrenous appendix and normal looking appendix. A majority (57%) of the patients had Alvarado scores of eight or more. None of the patients having a score of four or less was operated. Normal and perforated appendices were not found in patients having Alvarado scores of eight or more and seven or less, respectively. CONCLUSION: In this study, 8%, 16%, 19%, 22%, 26% and 9% of the patients undergoing appendectomy had Alvarado scores of five, six, seven, eight, nine and ten, respectively. An Alvarado score of seven was the most appropriate cutoff value for the decision to perform appendectomy. KEY WORDS: Alvarado score, Appendicitis, Appendectomy.

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