title: How reliable is the Alvarado score in acute appendicitis?
abstract: BACKGROUND
  We aimed to investigate the reliability of the Alvarado score (AS) in determining acute appendicitis and the different parameters that affect the AS.
  
  
  METHODS
  Three hundred and thirteen patients suspected of acute appendicitis (AA) aged 18-70 years were included in this study. Patient data including AS calculated from emergency services and at discharge, follow-up, and operations were recorded. Patients were divided into three groups according to the AS, as AS <4, AS 5-7 and AS 8-10. AA and appendicitis perforation rates were compared according to the different parameters.
  
  
  RESULTS
  The mean age of patients (55% females, 45% males) was 30.8±10.8 years. The AA (appendix perforation) rates of 211 patients who underwent operation were found as: AS ≤4: 56.5% (7.7%), AS 5-7: 75.9% (10%), and AS 8-10: 89% (27.8%). The percentage of negative appendectomy was 19.4%. The scoring was more reliable in males with AS 5-7, and the reliability weakened as body mass index (BMI) increased in all groups.
  
  
  CONCLUSIONS
  Patients with AS ≤4 must be followed up and should be informed at the time of their discharge about the slight possibility of appendicitis. The effect of AS in determining the diagnosis of appendicitis is not influenced by age or symptom duration.
authors.affiliation: Department of General Surgery, Tatvan State Hospital, Bitlis, Turkey.
authors.forename: Yücel
authors.initials: Y
authors.lastname: Yüksel
authors.affiliation: Department of General Surgery, Atatürk State Hospital, Antalya, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Dinç
authors.affiliation: Department of Anaesthesiology, Tatvan State Hospital, Bitlis, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Yüksel
authors.affiliation: Department of Emergency Medicine, Akdeniz University Faculty of Medicine, Antalya, Turkey.
authors.forename: Selcan Enver
authors.initials: SE
authors.lastname: Dinç
authors.affiliation: Department of General Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey.
authors.forename: Ayhan
authors.initials: A
authors.lastname: Mesci
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001064:Appendicitis / Q000175:diagnosis*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D055815:Young Adult