REVISITING ALVARADO SCORE FOR NEGATIVE APPENDICECTOMY RATE AT AYUB TEACHING HOSPITAL ABBOTTABAD

Area of Science:

• Medical Diagnostics
• Surgical Outcomes
• Clinical Scoring Systems

Background:

• Junior surgeons in developing countries often face challenges diagnosing Acute Appendicitis (AA) due to atypical presentations and limited access to advanced investigations.
• The Alvarado score is a widely used diagnostic tool, but its efficacy in current clinical practice needs re-evaluation.
• A structured diagnostic criterion is essential for accurate and timely appendicitis diagnosis.

Purpose of the Study:

• To reassess the diagnostic accuracy and utility of the Alvarado score in the current era.
• To evaluate the impact of the Alvarado score on the negative appendicectomy rate at Ayub Teaching Hospital (ATH).
• To determine the score's effectiveness in resource-limited healthcare settings.

Main Methods:

• A descriptive study involving 160 patients presenting with right iliac fossa (RIF) pain was conducted at ATH from September 2021 to May 2022.
• Patients were evaluated using the Alvarado score and categorized into three groups based on their scores (1-4, 5-6, and 7-10).
• Surgical intervention was based on scores, with follow-up and statistical analysis using SPSS version 26.

Main Results:

• Out of 160 patients, 22 were discharged (Group-1), 41 were observed (Group-2), and 122 underwent surgery (Group-3).
• Histopathology confirmed Acute Appendicitis in 109 of 122 surgically treated patients.
• The overall negative appendicectomy rate was 10.65%, with variations observed between males (6.17%) and females (19.51%).

Conclusions:

• The Alvarado score remains a valuable tool for diagnosing suspected Acute Appendicitis, even in contemporary practice.
• Routine adoption of the Alvarado score can help reduce the negative appendicectomy rate in resource-constrained environments like Pakistan.
• The study supports the continued use of the Alvarado score to improve diagnostic accuracy for appendicitis in developing countries.