Background:

Acute appendicitis is the most frequent surgical pathology in the emergency services. It affects approximately 9% of the population. Its differential diagnosis is extremely difficult especially in the elderly, children and women of childbearing age. The Alvarado score (AS) is a useful tool for suspected diagnosis of appendicitis. Our experience suggests the possibility of improving the diagnostic performance of this scale by including pain semiology.

Objective:

To compare the diagnostic utility of AS with and without including pain semiology used in the general surgery service of the high specialty naval hospital, as well as to identify fewer useful variables for the diagnosis.

Method:

The files of all the patients operated for the suspicion of acute appendicitis from March 2015 to March of the year 2017 were reviewed. The included patients have complete file and histopathological report. For each patient, diagnosis of appendicitis was established with the application of the AS and another, adding the pain semiology, and the result was contrasted with the histopathological diagnosis. The parameters of diagnostic utility were estimated, based on the cut points determined by the logistic regression model and the ROC curves.

Results:

AS modified with pain semiology showed greater diagnostic utility than the original scale. Six variables were also identified with a satisfactory performance.

Conclusion:

Pain semiology can improve the diagnostic utility of the current AS.

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