A comparative study of appendicitis inflammatory response score and alvarado score for patients with acute appendicitis at tertiary care hospital, belgaum – a prospective analytical study

Abstract

Background: Acute appendicitis still remains one of the most common abdominal emergency, demanding surgery. No perfect diagnostic evaluation tool exists to detect appendicitis if symptoms are ambiguous. With the advent of modern diagnostic tools, misdiagnosis of appendicitis has remained constant. Many scoring systems have been designed for diagnosis of acute appendicitis, among those, Alvarado system being simple to apply and efficacious. Aim: To compare Appendicitis Inflammatory Response Score (AIR) and Alvarado scoring systems in evaluating suspected cases of acute appendicitis. Materials & Methods: In a tertiary care hospital, 100 patients presenting with pain in the right lower quadrant of abdomen, who after clinical examination and relevant investigations were provisionally diagnosed to have acute appendicitis and warranting surgery for the same were evaluated using the scoring system – Alvarado Score and Appendicitis Inflammatory Response Score. The scores were tallied and compared with final histopathology report. The study was conducted for a period of one year. Results: AIR (at score >4) demonstrated a higher sensitivity and specificity compared to Alvarado score (89.9 vs 78.6%) and (63.6 vs 54.5) respectively. Alvarado showed a slightly better sensitivity at score>8 (21.3 vs 12.3%) respectively. Conclusion: Appendicitis Inflammatory Response Score outperformed Alvarado score . Such a scoring system is required for better diagnosis and avoid negative appendectomies.