Abstract

HERNANDEZ MIGUELENA, Luis  and  DOMINGUEZ SOLANO, David Román. Sensitivity and specificity of the Alvarado score in acute appendicitis, and its anatomopatological correlation at the High Specialty Regional Hospital of Veracruz. Cir. gen [online]. 2012, vol.34, n.3, pp.179-184. ISSN 1405-0099.

Objective: To determine the sensitivity and specificity of the Alvarado Score for the diagnosis of acute appendicitis at a high specialty regional hospital. Setting: High specialty regional hospital in the city of Veracruz, Veracruz, Mexico. Design: Cross-sectional, descriptive, ambispective observational study. Statistical analysis: Binary logistic regression, chi square (χ²), odds ratio and ROC curves. Results: The study included 384 (293 retrospective and 91 prospective) patients with a diagnosis of probable appendicitis and who were operated. Statistical analysis revealed that a better diagnostic accuracy is achieved with the Alvarado Score at a cut off >5, with a sensitivity of 0.96%, specificity of 0.72, positive predictive value of 0.93% and negative predictive value of 0.82. The most frequently found criterion was pain in the right iliac fossa positive in 100% of patients with appendicitis subjected to surgery; however, the most specific criterion was the rebound with 94.3% of patients. Conclusion: Criteria of the Alvarado Score are a useful tool for the diagnosis of acute appendicitis, it is applicable to all patients with acute abdominal pain suggestive of appendicitis as an admittance test, and to discard appendicular pathology in 5 points or less.

Keywords : Appendicitis; diagnosis; Alvarado Score.

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