Alvarado score as an admission criterion for suspected appendicitis in adults.
BACKGROUND
Acute appendicitis is a common surgical problem.


OBJECTIVE
To assess Alvarado score as an admission criterion for adult patients with suspected appendicitis in order to decrease unnecessary admissions to surgical wards.


METHODS
A prospective study of consecutive patients attending the Emergency Department (ED) of Riyadh Medical Complex with suspected appendicitis. The patients were managed according to the algorithm of the study protocol and discharged after clinical improvement either from ED or from the ward. They were followed by telephone 2-3 days later. Alvarado score was obtained in the ED in all patients.


RESULTS
The study included 211 patients, 60 patients were observed in ED and discharged, 151 patients were admitted and 137 of them were operated with a negative rate of 12.5%. The remaining 14 patients were observed and discharged. No patients with a score of 4 or less had appendicitis.


CONCLUSIONS
Though the diagnosis of acute appendicitis remains mainly clinical, Alvarado score can be recommended as a helpful tool for the admission criteria and further management in order to reduce unnecessary admissions and to reduce the morbidity and mortality of acute appendicitis.
Department of Surgery, Riyadh Medical Complex, Riyadh, Saudi Arabia.
Hamad Hadi
HH
Al Qahtani
Abdulmajeed Abdulhameed
AA
Muhammad