The reliability of alvarado score in the diagnosis of acute apandicitis

Apendectomy is the most frequently performed operation in all age groups. The aim of the operation is to decrease negative apendectomy and perforation rates. Alvarado score (AS) which is a scoring system based on symptoms, physical findings and laboratory results has been designed in 1986. The aim of this study is to search the reliability of Alvarado score based on age, sex and body mass index (BMI). Between May 2007 and 2009, three hundred and thirteen patients who were admitted Akdeniz University Hospital Emergency Department with the diagnosis of appendicitis, ages 18-70 yrs, were included in this study. The exclusion criteria's were pregnancy, confirmed malignancy, previous laparatomy and palpated intraabdominal mass. The treatment strategy was planed by primary physician not considering Alvarado score. The data for admission of patient, operation, follow-up were recorded. The rate of negative laparatomy and perforation was recorded. The reliability of Alvarado score were compared according to Ultrasound finding, age and symptom period. In conclusion; In AS ≤ 4 patients , perforation or acute appendicitis can be seen with a low ratio ; AS ≤ 4 patients have to be followed up, and be informed about possibility of acute appendicitis; AS 5-7 male patient has a high possibility of acute appendicitis. AS is a highly reliable scoring system in patients whose BMI > 25. AS is not affected by duration of symptoms and patient's age. Key words: Acute appendicitis, Alvarado Score.