title: Evaluation of the Alvarado score in acute abdominal pain.
abstract: BACKGROUND
  The Alvarado score is utilized to determine the likelihood of appendicitis based on clinical signs, symptoms, and laboratory results. The goal of this study was to determine whether Alvarado scores can be used to aid in the accurate diagnosis of appendicitis.
  
  
  METHODS
  Alvarado score evaluations were performed on 300 patients that were referred to or presented to the emergency room with acute abdominal pain.
  
  
  RESULTS
  Out of the 300 patients, 85.66% had Alvarado scores of 7 or less and 14.33% had Alvarado scores greater than 7. For patients that had confirmed appendicitis, 25.7% had Alvarado scores of 7 or less, whereas 93% had Alvarado scores greater than 7. The Alvarado scoring system had poor sensitivity at 37%, and the specificity of this scoring system was high at 95%.
  
  
  CONCLUSIONS
  Our findings suggest that patients presenting with abdominal pain and Alvarado scores greater than 7 are more likely to have appendicitis. As such, the Alvarado scoring system may be utilized to better predict whether a patient has appendicitis. An Alvarado score that is positive for appendicitis would consist of a score greater than 7, which suggests that the patient has a 93% chance of having appendicitis. A negative Alvarado score is 7 or lower, suggesting a 26% probability of having appendicitis. In all, the Alvarado scoring system is a good rule-in test, but it does not adequately rule-out appendicitis.
authors.affiliation: Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Kariman
authors.affiliation: Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Shojaee
authors.affiliation: Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Anita
authors.initials: A
authors.lastname: Sabzghabaei
authors.affiliation: Department of Emergency Medicine, Birjand University of Medical Sciences, Khorasan, Iran.
authors.forename: Rosita
authors.initials: R
authors.lastname: Khatamian
authors.affiliation: Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hojjat
authors.initials: H
authors.lastname: Derakhshanfar
authors.affiliation: Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Hatamabadi
mesh_terms: D015746:Abdominal Pain / Q000503:physiopathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy; D001064:Appendicitis / Q000175:diagnosis; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D055815:Young Adult