Yousaf Jan, Waqas, Shaukat Hussain.
Diagnostic Value of Modified Alvarado Scoring System in the Diagnosis of Acute Appendicitis and its Correlation with Histopathology.
Ophthalmol Update Jan ;12(4):313-7.

Background: Acute appendicitis is a common surgical emergency and approximately 7% of the population will have appendicitis in their life time. Early diagnosis and prompt surgical treatment is necessary to prevent complications. The diagnosis of acute appendicitis is still based primarily on the clinical history examination, and the accuracy of clinical examination has been reported from 71 % to 97 %. The treatment being surgical, and various scoring systems are available for diagnosis to prevent the increasing negative appendectomy rate. Objective: The aim was to evaluate the Modified Alvarado Scoring Systems in clinical practice for the diagnosis of acute appendicitis and its correlation by histopathology. Material and Methods: This randomized controlled study was conducted in Agency Headquarter Hospital Landikotal from October 2012 to July 2013. 160 patients with suspected acute appendicitis were admitted in the ward and were evaluated on the basis of Modified Alvarado Scoring System. Decision regarding surgical intervention was made on the basis of change in the score. Results: A total of 160 patients were included in the study. Among them, 105 (65.62%) were males and 55 (34.37%) were females. Age ranged from 11-60 years. Twelve patients had MASS of 1-4 and two out of them required surgery. Twenty two patients were in the score of 5-7, and fourteen out of them required surgery. One hundred and twenty six had score 8 and above , all of them underwent surgery. Out of 142 patients who required surgery, 132 patients had appendicitis on histopathology, yielding a positive predictive value of 92.95 %, while the rate of negative appendectomy was 7.05 %. Conclusion: The study shows that use of modified Alvarado scoring system is a good diagnostic indicator in the diagnosis of suspected appendicitis as compared to simple clinical assessment and helps in minimizing negative appendectomy rates.

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