A One Year Cross-Sectional Study to Evaluate Specificity and Sensitivity of Modified Alvarado Score and Ultrasonography in Acute Appendicitis of Patients Coming to K.L.E.S Dr. Prabhakar Kore Hospital, Belgaum

Abstract

Background and objectives ABSTRACT Several diagnostic aids have been developed to improve diagnosis in suspected acute appendicitis. Modified Alvarado score includes signs and symptoms associated with ones degree of clinical suspicion. Ultrasonograpy is used in many institutions to aid the diagnosis of acute appendicitis, the following study evaluate and compare the diagnostic accuracy of the two modalities and examines value of using both modalities together. The aim of present study is to compare and evaluate diagnostic accuracy of modified Alvarado score and ultrasonography in co-relation to histopathology report for diagnosis of acute appendicitis. Methods : A cross-sectional study of the patients who underwent appendectomy for suspected acute appendicitis at K.L.E.S. Dr. Prabhakar Kore Hospital and M.R.C Belgaum. The clinical, radiological and ultrasonograhic data of 75 patients with suspected appendicitis was collected these patients were evaluated by modified Alvarado score and ultrasonography, which was correlated with histopathological findings. Results : Out of 75 patients, 29 patients ( 38.66% ) had acute appendicitis. 30 patients ( 40% ) had modified Alvarado score  7 and 29 patients ( 38.66% ) were ultrasonographically positive. In the present study, modified Alvarado score has sensitivity of 75.86%, specificity 82.61%, positive predictive value 73.33%, negative predictive value 84.44%, diagnostic accuracy 80.0%, false positive error rate 17.39% and false negative error rate 24.11%. X Ultrasonography has sensitivity of 82.76%, specificity 89.13%, positive predictive value 82.76%, negative predictive value 89.13%, diagnostic accuracy 86.67%, false positive error rate 10.87% and false negative error rate 17.24%. When modified Alvarado score and ultrasonography were positive, 26 were true positive cases, and no false positive cases. The false negative cases modified Alvarado score were 7. When it was combined with ultrasonography the false negative cases reduced to three that is 57.14% reduction in false negative cases. Conclusions : Modified Alvarado is useful tool in clinical decision making. When compared with ultrasonography, neither one is advantageous. However, additional information provided by ultrasonography improves diagnostic accuracy.