A Comparative Study of Adult Appendicitis Score with Alvarado Score in the Diagnosis of Acute Appendicitis

Abstract

Introduction: For individuals suspected of having acute appendicitis, clinical evaluation based on a history and physical examination has been the main diagnostic approach.  Although a number of diagnostic methods, such as imaging modalities and biochemical assays, have been developed, advanced diagnostic testing has not improved the detection of acute appendicitis.  This diagnostic difficulty has led to the need for objective techniques of using scoring systems to evaluate those who may have acute appendicitis. Methodology: The study comprised 180 patients, aged 20 to 60 years presenting with suspected acute appendicitis undergoing appendectomy. Participants in this study were excluded if they had an appendicular mass or abscess, were pregnant, had undergone a laparotomy, had had an appendectomy, or had Koch's abdomen or inflammatory bowel disease. The cutoff point for a higher risk or probability/positive test of acute appendicitis was defined as an Alvarado scale score of ≥ 7 or higher. The cutoff point for a high risk or probability/positive test of acute appendicitis was defined as an Adult Appendicitis Score of ≥ 11 or above. The diagnostic accuracy of Alvarado and AAS was computed by comparing the histopathological results with the preoperative scores. Results: Acute appendicitis was diagnosed with a sensitivity of 93.85% Adult Appendicitis Score, a specificity of 80.0%, a PPV of 92.42%, an NPV of 83.33%, and a diagnostic accuracy of 90.0%. Acute appendicitis was diagnosed with a sensitivity of 90.72% alvardo score, a specificity of 72.0%, a PPV of 89.31%, an NPV of 73.47%, and a diagnostic accuracy of 85.0%. Conclusion: For the precise diagnosis of acute appendicitis, the Adult Appendicitis Score offers higher sensitivity and specificity.