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Alvarado score in the diagnosis of acute appendicitis: correlation with the tomographic and intra-operative findings


International Journal of Radiology & Radiation Therapy
Christian Spina, Ana Paula Marconi Iamarino, Otto Mauro dos Santos Rosa and Marcelo Augusto Fontenelle Ribeiro
Universidade Santo Amaro, Brasil
Christian Spina, Universidade Santo Amaro, Brazil
Ana Paula Marconi Iamarino, Universidade Santo Amaro, Brazil
Otto Mauro dos Santos Rosa , Universidade Santo Amaro, Brazil

Abstract

Background: Acute appendicitis is one of the most common causes of abdominal pain, accounting for about one-third of patients presenting at emergency services with acute abdomen. A high degree of suspicion is essential for diagnosis.
Aim: Evaluate the correlation between the Alvarado score and the tomographic and intraoperative findings of patients with acute appendicitis.
Methods: Descriptive, cross-sectional, retrospective study  using data obtained from the Internment Management System of all hospitalized patients with acute appendicitis from June 2014 to June 2015. Data  were analyzed and Statistics generated through the Epi Info 7.0 program.
Results: 240 patients were evaluated. Of these, 150 (62.5%) were male and 90 (37.5%) were female, with a mean age of 28.6 years. The exclusive clinical diagnosis was performed in 42 patients (17.4%). The relationship between the positive Alvarado score and the tomographic findings was evaluated, being considered positive in the presence of two or more findings. The positive association between Positive Alvarado Score and the presence of tomographic findings was obtained, with Odds Ratio of 1.665 and P=0.1805. The association between the intraoperative findings and the positive Alvarado score was evaluated, in which 8 (11.11%) patients were in the edematous phase (Odds Ratio=0,8182 P=0,6474), 31(43,05%) were phlegmonous (Odds Ratio= 0,8128, P=0,4655), 15(20.83%) in the gangrenous phase (Odds Ratio=0,9175, P=0,8028) and 18 (25%) in the perforated phase (Odds Ratio=1,7949, P=0,1278).
Conclusion: There is a positive association between Alvarado score and the presence of tomographic findings, as well as the association between positive Alvarado score and perforation phase.

Keywords

Appendicitis, Appendectomy, Acute abdomen, Tomography, Diagnosis, tomographic findings, Acute appendicitis, Child-bearing, Appendectomies, Surgeons, Abdomen, Appendectomy, Young, Elderly, Morbidity, Mortality

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