Diagnostic effectiveness of alvarado score and proadrenomedullin level in patients with acute appendicitis

INTRODUCTION AND AIM: In this study, it was aimed to reveal the effectiveness of MR-proADM level and Alvarado Score in the diagnostic approach in patients who applied to the emergency department with the complaint of abdominal pain and diagnosed with acute appendicitis. MATERIALS AND METHODS: This randomized, controlled and prospective study was conducted with 150 patients who admitted to Sakarya University Training and Research Hospital Emergency Medicine Clinic and were accepted to participate in the study among the patients suspected of having acute appendicitis at the initial evaluation. For statistical analysis, IBM SPSS Statistics 22 New York program was used and p<0.05 values were considered significant. RESULTS: A total of 150 patients were included in the study. Of the patients, 83 (55.3%) were male and 67 (44.7%) were female. The mean age of the patients was 38.07. A statistically significant difference was found in the MR-proADM level in the diagnosis of acute appendicitis. When the cut-off value of 0.78 was taken for the MR-proADM level, the diagnostic sensitivity was 100%, the specificity was 50%. Alvarado score was also found to be statistically significant for the diagnosis of acute appendicitis, and when the cut-off value was 3, diagnostic sensitivity was 98.7%, specificity was 87.1%. CONCLUSION: MR-proADM and Alvarado Score were found to be significantly higher in acute appendicitis patients than in patients with nonspesifik abdominal pain. However, neither parameter was found to be significant in the differentiation of simple and complicated acute appendicitis. Concomitant use may help to exclude the diagnosis of acute appendicitis due to its high sensitivity and negative predictive value. Key Words: Acute Appendicitis, Alvarado Score, Abdominal Pain, Mid Regional Pro-Adrenomedullin, Nonspecific Abdominal Pain