Indian Journal of Surgery

, Volume 72, Issue 4, pp 290–293 | Cite as

Alvarado Scoring in Acute Appendicitis—A Clinicopathological Correlation

  • Subhajeet Dey
  • Pradip K. Mohanta
  • Anil K. Baruah
  • Bikram Kharga
  • Kincho L. Bhutia
  • Varun K. Singh
Original Article


Acute appendicitis is a clinical diagnosis, so it’s impossible to have a definitive diagnosis by gold standard (histopathology) pre operatively. The treatment being surgical, negative appendicectomy rates are high. Present study was conducted to evaluate Alvarado scoring system for diagnosis of acute appendicitis and its co relation by histopathology. Retrospective study of consecutive patients admitted with suspected acute appendicitis during the period March 2005 to March 2007. The Alvarado scoring system was computed from admission notes and records and correlated with the histopathology reports. Out of 155 patients, 92 underwent appendicectomy with the intention to treat appendicitis and diagnosis was confirmed in 80 patients. Reliability of scoring system was assessed by calculating negative appendicectomy rate and positive predictive value. The normal appendicectomy frequency was 13% and positive predictive value was 86%. Alvarado scoring system is easy, simple, cheap, useful tool in pre operative diagnosis of acute appendicitis and can work effectively in routine practice.


Alvarado scoring Acute appendicitis Histopathology 


  1. 1.
  2. 2.
    Peterson MC, Holbrook JH, Von Hales D et al (1992) Contributions of history, physical examination and laboratory investigations in making medical diagnosis. West J Med 156:163–165PubMedGoogle Scholar
  3. 3.
    Dado G, Anania G, Baccarani U et al (2000) Application of a clinical score for the diagnosis of acute appendicitis in childhood. J Pediatr Surg 35:1320–1322PubMedCrossRefGoogle Scholar
  4. 4.
    Kalan M, Talbot D, Cunliffe WJ et al (1994) Evaluation of the modified Alvarado score in the diagnosis of acute appendicitis: a prospective study. Ann R Coll Surg 76:418–419Google Scholar
  5. 5.
    Ohmann C, Franke C, Yang Q (1999) Clinical benefit of diagnostic score for appendicitis: results of a prospective interventional study. German study group of acute abdominal pain. Arch Surg 134:993–996PubMedCrossRefGoogle Scholar
  6. 6.
    Alvarado A (1986) A practical score for early diagnosis of acute appendicitis. Ann Emerg Med 15:557–564PubMedCrossRefGoogle Scholar
  7. 7.
    Jawaid A, Asad A, Motiei A et al (1999) Clinical scoring system: a valuable tool for decision making in cases of acute appendicitis. J Pak Med Assoc 49(10):254–259PubMedGoogle Scholar
  8. 8.
    Baidya N, Rodrigues G, Rao A, et al (2007) Evaluation of Alvarado score in acute appendicitis: a prospective study. Internet J Surg 9(1)Google Scholar
  9. 9.
    Chan MY, Teo BS, Ng BL (2001) The Alvarado score and acute appendicitis. Ann Acad Med Singapore 30(5):510–512PubMedGoogle Scholar
  10. 10.
    Khan I, ur Rehman A (2005) Application of Alvarado scoring in diagnosis of acute appendicitis. J Ayub Med Coll Abbottabad 17(3):41–44PubMedGoogle Scholar
  11. 11.
    Ohmann C, Yang Q, Franke C (1995) The abdominal pain study group. Diagnostic scores for acute appendicitis. Eur J Surg 161:273–281PubMedGoogle Scholar
  12. 12.
    Abdeldaim Y, Mahmood S, Mc Avinchey D (2007) The Alvarado score as a tool for diagnosis of acute appendicitis. Ir Med J 100(1):342PubMedGoogle Scholar
  13. 13.
    Denizbasi A, Unluer EE (2003) The role of the emergency medicine resident using the Alvarado score in the diagnosis of acute appendicitis compared with the general surgery resident. Eur J Emerg Med 10(4):296–301PubMedCrossRefGoogle Scholar
  14. 14.
    Bond GR, Tully SB, Chan LS et al (1990) Use of MANTRELS score in childhood appendicitis: a prospective study of 187 children with abdominal pain. Ann Emerg Med 19(9):1014–1018PubMedCrossRefGoogle Scholar

Copyright information

© Association of Surgeons of India 2010

Authors and Affiliations

  • Subhajeet Dey
    • 1
  • Pradip K. Mohanta
    • 1
  • Anil K. Baruah
    • 1
  • Bikram Kharga
    • 1
  • Kincho L. Bhutia
    • 1
  • Varun K. Singh
    • 1
  1. 1.Sikkim Manipal Institute of Medical SciencesSikkimIndia

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