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KMID : 0371320100780020100
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Journal of the Korean Surgical Society
2010 Volume.78 No. 2 p.100 ~ p.105
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Diagnostic Efficacy of the Alvarado Score according to Age in Acute Appendicitis
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Oh Bo-Young
Kim Kwang-Ho
Lee Ryung-Ah
Chung Soon-Sup
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Abstract
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Purpose: This study aims to assess the diagnostic efficacy of the Alvarado score and to determine cut-off values of Alvarado score according to age for deciding on the options for patients with suspected appendicitis.
Methods: From October 2008 to January 2009, we prospectively reviewed 152 patients with suspected appendicitis. The patients were classified into adults and children groups. We then determined cut-off values of the Alvarado score by analyzing each score’s sensitivity and specificity.
Results: Of the 147 patients, 96 patients were adults and 51 were children. The mean Alvarado score for adults and children were 6.08±1.85, and 6.69±1.43 in appendicitis and 4.32±2.02, and 4.60±1.81 in non-appendicitis, respectively. In adults, the sensitivity of the Alvarado scores 7 or higher for appendicitis was 66.2%, and the specificity was 67.7%. And the sensitivity of the Alvarado scores 4 or lower for non-appendicitis was 58.1%, and the specificity was 81.5%. In children, the sensitivity of the Alvarado scores 7 or higher for appendicitis was 80.8%, and the specificity was 68.0%. And the sensitivity of the Alvarado scores 4 or lower for non-appendicitis was 52.0%, and the specificity was 92.3%.
Conclusion: The cut-off values for Alvarado score were not different according to age of the patient. If the Alvarado score is 7 or higher, surgical management is recommended, and if the Alvarado score is 4 or lower, observation without CT or US is recommended. In equivocal appendicitis as defined by the Alvarado scores 5 to 6, adjunctive CT or US are recommended to confirm appendicitis.
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KEYWORD
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Acute appendicitis, Alvarado score, Age
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