Year 2017, Volume 1 , Issue 2, Pages 28 - 31 2017-08-27

Original Alvarado scoring system in the diagnosis of acute appendicitis: A cohort study.
Akut apandisit tanısında orijinal Alvarado skorlama sistemi: Kohort çalışma.

Yahya Kemal ÇALIŞKAN [1]


Aims: Although acute appendicitis is the most common cause of acute abdomen, there is still no definitive diagnostic method. Various scores were defined in the literature. In this study, we investigated the effectiveness of the Alvarado score, a clinical scoring system aimed at supporting the diagnosis.

Methods: Patients who were to be operated with acute abdomen and acute appendicitis pre-diagnosis in our hospital emergency surgery service were calculated before the Alvarado scores. This score has 8 parameters in the system. 1-The right lower quadrant of pain, 2-anorexia, 3-nausea-vomiting, 4-right lower quadrant sensitivity, 5-rebound sensitivity, 6-fever, 7-leukocytosis, 8-left shift (granulocytosis). Numbers 4 and 7 are calculated with a total of 10 points, 2 points, 1 point.

Results: Total 200 patients, (128 males, 82 female, male/female: 1.6) mean age was 34.3 ± 15.6, and the age range was 15-78. In ROC analysis, Alvarado scores greater than 6 has demonstrated acute appendicitis diagnosis with 76% sensitivity and 91% specificity. Alvarado score of 9-10 showed 100% sensitivity to detect acute appendicitis.

Conclusions: Clinical scoring systems are frequently used in the diagnosis of acute appendicitis. In publications covering the Alvarado scores of 9-10, the high probability of appendicitis, needs surgical intervention, and advanced examination methods were proposed in scores of 7-8. Our study resulted in consistent with the literature.

Amaç: Akut apandisit en sık görülen akut karın nedeni olmasına rağmen hala kesin tanı koyduran bir yöntem mevcut değildir. Literatürde çeşitli skorlamalar tanımlanmıştır. Bu çalışmada tanıyı desteklemek amaçlı, bir klinik skorlama sistemi olan Alvarado skorununun etkinliği araştırdık.

Yöntem: Hastanemiz acil cerrahi servisinde akut karın ve akut apandisit ön tanısı ile ameliyat edilecek hastalara, ameliyat öncesinde Alvarado skorları hesaplandı. Bu skor sistem içerisinde 8 parametre bulunmaktadır. 1-Ağrının sağ alt kadrana göçü, 2-İştahsızlık, 3-Bulantı-kusma, 4-Sağ alt kadranda hassasiyet, 5-Rebound hassasiyet, 6-Ateş, 7-Lökositoz, 8-Sola kayma (granülositoz). 4 ve 7 numara 2 puan diğerleri 1 puan olmak üzere toplam 10 puan üzerinden hesaplanır.

Bulgular: Toplam 200 hasta, (128 erkek, 82 bayan, erkek/bayan:1.6) ortalama yaş 34.3±15.6, yaş aralığının 15-78 olduğu görüldü. ROC analizinde 6’nın üzerindeki Alvarado skorlarının %76 sensitivite, %91 spesifisite ile akut apandisit tanısını gösterebileceği saptandı. Alvarado skoru 9-10 %100 sensitivite ile akut apandisiti tespit etti.

Sonuçlar: Akut apandisit tanısında klinik skorlama sistemleri sık kullanılmaktadır. Alvarado skorlama sistemini kapsayan yayınlarda 9-10 arası yüksek ihtimal apandisit (cerrahi girişim), 7-8 arası değerler için ileri tetkik yöntemleri önerilmiştir. Çalışmamızda literatürle uyumlu sonuçlanmıştır.

  • 1. Peterson MC, Holbrook JH, Hales D, Smith, NL, Staker, LV. Contributions of history, physical examination and laboratory investigations in making medical diagnosis. West J Med 1992;156:163-5.
  • 2. Anderson RE, Hugander A, Thulin AJ. Diagnostic accuracy and perforation rate in appendicitis: Association with age and sex of the patient and with appendectomy rate. Eur J Surg 1992; 158: 37-41.
  • 3. John H, Mathiessen FK, Neckelmann K, Hovendal CP, Bellstorm T, Gottrup F. Comparison of clinic judgment and diagnostic ultrasonography in the diagnosis of acute appendicitis experience with a score-aided diagnosis. Eur J Surg 1997;163:433-443.
  • 4. Steven LL, Alicia JW, Hung SH. Computed tomography and ultrasonography do not improve and may delay the diagnosis and treatment of acute appendicitis. Arch Surg 2001;136: 556-562.
  • 5. Colson M, Skinner KA, Dunnignton G. High negative appendectomy rates are no longer acceptable. Am J Surg 1997;174:723-6.
  • 6. Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med 1986 May;15(5):557-64.
  • 7. Augustin G, Majerovic M. Non-obstetrical acute abdomen during pregnancy. Eur J Obstet Gynecol Reprod Biol 2007;131:4-12.
  • 8. Selçuk S. Ruptured heterotopic pregnancy: Case report. J Surg Med. 2017;1:15-17.
  • 9. Terasawa T, Blackmore CC, Bent S, Kohlwes RJ. Systematic review: Computed tomography and ultrasonography to detect acute appendicitis in adults and adolescents. Ann Intern Med 2004; 141: 537-546.
  • 10. Vidmar D, Omejc M, Cerar A, Makiar J, Repse S. Influence of ultrasonography on clinical decision making in suspected acute appendicitis in adults. Eur Surg 2006; 38: 445–450.
  • 11. Maroju NK, Robinson Smile S, Sistla SC, Narasimhan R, Sahai A. Delay in surgery for acute appendicitis. ANZ J Surg 2004;74:773-6.
  • 12. Rastović P, Trninić Z, Galić G, Brekalo Z, Lesko J, Pavlović M. Accuracy of Modified Alvarado Score, Eskelinen Score and Ohmann Score in Diagnosing Acute Appendicitis. Psychiatr Danub 2017;29:134-141.
  • 13. Singla A, Singla S, Singh M, Singla D. A comparison between modified Alvarado score and RIPASA score in the diagnosis of acute appendicitis. Updates Surg 2016;68:351-355.
  • 14. Bergeron E. Clinical judgement remains of great value in the diagnosis of acute appendicitis. J Can Chir 2006;49:96-100.
Subjects Surgery
Journal Section Research article
Authors

Author: Yahya Kemal ÇALIŞKAN
Country: Turkey


Dates

Publication Date : August 27, 2017

Bibtex @research article { josam342221, journal = {Journal of Surgery and Medicine}, issn = {}, eissn = {2602-2079}, address = {jsurgmed@gmail.com}, publisher = {Fatih BAŞAK}, year = {2017}, volume = {1}, pages = {28 - 31}, doi = {10.28982/josam.342221}, title = {Original Alvarado scoring system in the diagnosis of acute appendicitis: A cohort study.}, key = {cite}, author = {Çalışkan, Yahya Kemal} }
APA Çalışkan, Y . (2017). Original Alvarado scoring system in the diagnosis of acute appendicitis: A cohort study. . Journal of Surgery and Medicine , 1 (2) , 28-31 . DOI: 10.28982/josam.342221
MLA Çalışkan, Y . "Original Alvarado scoring system in the diagnosis of acute appendicitis: A cohort study." . Journal of Surgery and Medicine 1 (2017 ): 28-31 <http://jsurgmed.com/en/pub/issue/31222/342221>
Chicago Çalışkan, Y . "Original Alvarado scoring system in the diagnosis of acute appendicitis: A cohort study.". Journal of Surgery and Medicine 1 (2017 ): 28-31
RIS TY - JOUR T1 - Original Alvarado scoring system in the diagnosis of acute appendicitis: A cohort study. AU - Yahya Kemal Çalışkan Y1 - 2017 PY - 2017 N1 - doi: 10.28982/josam.342221 DO - 10.28982/josam.342221 T2 - Journal of Surgery and Medicine JF - Journal JO - JOR SP - 28 EP - 31 VL - 1 IS - 2 SN - -2602-2079 M3 - doi: 10.28982/josam.342221 UR - https://doi.org/10.28982/josam.342221 Y2 - 2017 ER -
EndNote %0 Journal of Surgery and Medicine Original Alvarado scoring system in the diagnosis of acute appendicitis: A cohort study. %A Yahya Kemal Çalışkan %T Original Alvarado scoring system in the diagnosis of acute appendicitis: A cohort study. %D 2017 %J Journal of Surgery and Medicine %P -2602-2079 %V 1 %N 2 %R doi: 10.28982/josam.342221 %U 10.28982/josam.342221
ISNAD Çalışkan, Yahya Kemal . "Original Alvarado scoring system in the diagnosis of acute appendicitis: A cohort study.". Journal of Surgery and Medicine 1 / 2 (August 2017): 28-31 . https://doi.org/10.28982/josam.342221
AMA Çalışkan Y . Original Alvarado scoring system in the diagnosis of acute appendicitis: A cohort study.. J Surg Med. 2017; 1(2): 28-31.
Vancouver Çalışkan Y . Original Alvarado scoring system in the diagnosis of acute appendicitis: A cohort study.. Journal of Surgery and Medicine. 2017; 1(2): 28-31.