A Comparative Study to Assess Efficacy of Tzanakis Score and alvarado score for Effective Diagnosis of Patients with Acute Appendicitis at KLE Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum - A One Year Prospective Analytical Study

Abstract

INTRODUCTION: -Acute appendicitis standout amongst the most widely recognized reasons for intense stomach torment. This condition warrants quick heath care and treatment. It is by and large connected with noteworthy dismalness and mortality. Anyway death rate has improved after the rise of anti-infection agents in 1940. Due to dietary propensities for the Asians the frequency of acute appendix is low when contrasted with western populace. The consistency of faeces, bowel travel time and development of appendicolith is diminished by dietary modifications.There is no ideal symptomatic assessment apparatus to distinguish acute appendix if indications are ambiguous, bringing about longer analytic procedure and it might prompt deferring of medical procedure and related increment in morbidity and fatality. In the meantime, speedy management may prompt negative appendectomy with expanded horribleness and consumption of treatment. AIMS AND OBJECTIVES:-To establish the diagnosis of AA in a more efficacious manner by using Tzanakis score and Alvarado scoring system and evaluate the efficacy of both scoring system by comparison. MATERIALS AND METHODS:- A Hospital based one year Prospective Study was conducted in the Department of General surgery , KLE’S Dr.Prabhakar Kore Hospital and Medical Research Centre, Belagavi from 1st January 2018to 31st December 2019 and required data was collected from 100 patient who were clinically diagnosed to have acute appendicitis and all patients were assessed using Alvarado score and Tzanakis score and HPR for all patients were used as gold standard to evaluate the efficacy of both scoring systems. RESULTS: - In the present study the age span ranged 19 to 93 years.Maximum patients were in age group 18 to 40 years (83%). Pain in right lower quadrant was the most common presenting complain (100%) followed by anorexia (61%) and nausea/Vomiting (48%). The sensitivity and specificty of Tzanakis score was 80.6 % (at score >8 ) and 100% (at score >8) respectively. PPV in present study being 100% and NPV being 41.3%. The sensitivity and specificty of Alvarado score was 11.3 % (at score >8 ) and 100% (at score >8) respectively . The negative appendectomy rate in the present study is 12% which is comparable and acceptable (15-20%) among various studies. CONCLUSION:-Although acute appendicitis is commonest surgical emergency, its management is still challenging. Tzanakis Score outperformed Alvarado score displaying higher sensitivity with similar specificity. Ultrasound is a useful tool in diagnosing patients of Acute appendicitis