How successful are Alvarado and air scores in excluding gynecopathologies?

Alvarado and acute inflammatory response (AIR) scoring systems are the most common clinical diagnostic scoring systems for the diagnosis of acute appendicitis. We investigated how successful these scorings are in terms of excluding urgent gynecological pathologies.

Patients who underwent emergency surgery by the general surgery team due to acute abdomen clinic in our hospital between 2018 and 2023 and were detected to have gynecological pathology during the operation were included in the study. General medical characteristics of the patients, preoperative laboratory values, findings in preoperative imaging, Alvarado and AIR scores, final diagnoses, and surgical procedures performed were recorded.

A total of 78 patients were included in the study, 39 patients forming the case group and 39 patients forming the control group. No significant difference was found between the control and case groups in terms of the age of the patients, presence of additional diseases, and WBC value (p: 0.877, p: 0.092, p: 0.500). While the rate of normal findings on ultrasonography (USG) in the case group was significantly lower than in the control group (p: 0.001), the rate of normal findings on computed tomography (CT) was significantly higher than in the control group (p: 0.000). CRP value and length of stay in the case group were significantly higher than in the control group (p: 0.050, p: 0.000). There was no statistically significant relationship between Alvarado or AIR score of 9 or above and whether urgent gynecological pathology was detected (p: 0.073, p: 0.723).

It was observed that Alvarado and AIR scores failed to exclude urgent gynecological pathologies.