Evaluation of Alvarado score as an admission criterion in patients with suspected diagnosis of acute appendicitis.
BACKGROUND
Patients with right iliac fossa pain present a diagnostic challenge to emergency room doctors when equivocal signs are present.


OBJECTIVE
To evaluate Alvarado score as an admission criterion in patients with suspected diagnosis of acute appendicitis.


METHODS
This was a prospective study of 100 consecutive patients who presented to the an emergency department with right iliac fossa pain and suspected diagnosis of acute appendicitis between January 2004 and December 2004. They were assessed usingAlvarado score. Main outcome measures in relation to these scores were, patient's admission, patient's discharge, and whether patient had appendicitis or not.


RESULTS
The range of scores was 1-10. Seventy-four patients were admitted while 26 were discharged. Thirty-four patients with confirmed diagnosis of acute appendicitis had scores ranging from 5-10. No patient with score less than 5 had appendicitis. The sensitivity and negative predictive value reached 100% at scores below five, while specificity and positive predictive value reached 100% at the score of 10.


CONCLUSIONS
The Alvarado score can be used as an objective criterion in selecting for admission patients with suspected diagnosis of acute appendicitis. Patients with scores of 4 and below do not require admission since they turn out not to have acute appendicitis.
Tade
A O
AO
Department of Surgery, Olabisi Onabanjo University, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria.
D000006:Abdomen, Acute / Q000175:diagnosis; D000328:Adult; D001064:Appendicitis / Q000175:diagnosis* / Q000503:physiopathology; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D017699:Pelvic Pain / Q000175:diagnosis* / Q000503:physiopathology; D011446:Prospective Studies; D012720:Severity of Illness Index