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<p>Acute appendicitis is one of the most common causes of acute abdominal pain and is the most frequent surgical condition in the emergency room. The diagnosis is mainly clinical. Clinical examination is helpful in the diagnosis of acute appendicitis in approximately 80% of cases. An effective scoring system can be a good guiding tool to decide the diagnosis of patients with acute appendicitis to find the right balance between under- and over-diagnosis. Many scoring systems exist, but studies failed to prove the superiority of one over the other. This prospective study was undertaken to compare the efficacy of Alvarado score and Appendicitis Inflammatory Response score in the diagnosis of acute appendicitis. Alvarado scoring system is widely used to diagnose acute appendicitis. It consists of symptoms, signs, and inflammatory markers. Out of 10 scores, a score of 7 or more is considered acute appendicitis, requiring emergency surgical treatment. Appendicitis Inflammatory Response score system is a combination of clinical examination, laboratory parameters, and inflammatory markers. A score of 8 or more is considered acute appendicitis requiring surgical treatment. In my study, the diagnostic accuracy of Alvarado and AIR scores was calculated. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of Alvarado scores were 29.4%, 73.3%, 83.3%, 18.64%, and 37.35%, whereas for AIR score, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 60.29%, 73.33%, 91.11%, 28.95%, and 62.65%. The study was conducted in 83 patients who came to Sanjay Gandhi Memorial Hospital, New Delhi, during a period of 1&#xa0;year. The mean age of patients was 32.31&#xa0;years (17–76). Patients were more males (62.7%) than females (37.33%). Right lower quadrant pain was the most common symptom (100%) followed by anorexia (83.1), followed by nausea (68.7%) and vomiting (50%). The least common symptom was fever (15%). Tenderness in the RIF was the most common sign (95.2%). USG whole abdomen in 81.9% of patients was suggestive of acute appendicitis. The diagnosis was histopathologically confirmed in 53 cases (63.9%). Mean score of Alvarado score is 5.41. Mean score of AIR score is 4.96. And from these results, we derive that AIR has better diagnostic accuracy when compared to Alvarado score in predicting acute appendicitis.</p>

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A Comparative Study Between Appendicitis Inflammatory Response Score and Alvarado Score in diagnosis of Acute Appendicitis: A Prospective Study

  • 期刊论文

  • 发表日期：

    2025年8月14日

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  • Paras Manocha,
  • Nishi Gupta,
  • Ishita Chugh,
  • Sanjay Sharma

摘要

Acute appendicitis is one of the most common causes of acute abdominal pain and is the most frequent surgical condition in the emergency room. The diagnosis is mainly clinical. Clinical examination is helpful in the diagnosis of acute appendicitis in approximately 80% of cases. An effective scoring system can be a good guiding tool to decide the diagnosis of patients with acute appendicitis to find the right balance between under- and over-diagnosis. Many scoring systems exist, but studies failed to prove the superiority of one over the other. This prospective study was undertaken to compare the efficacy of Alvarado score and Appendicitis Inflammatory Response score in the diagnosis of acute appendicitis. Alvarado scoring system is widely used to diagnose acute appendicitis. It consists of symptoms, signs, and inflammatory markers. Out of 10 scores, a score of 7 or more is considered acute appendicitis, requiring emergency surgical treatment. Appendicitis Inflammatory Response score system is a combination of clinical examination, laboratory parameters, and inflammatory markers. A score of 8 or more is considered acute appendicitis requiring surgical treatment. In my study, the diagnostic accuracy of Alvarado and AIR scores was calculated. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of Alvarado scores were 29.4%, 73.3%, 83.3%, 18.64%, and 37.35%, whereas for AIR score, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 60.29%, 73.33%, 91.11%, 28.95%, and 62.65%. The study was conducted in 83 patients who came to Sanjay Gandhi Memorial Hospital, New Delhi, during a period of 1 year. The mean age of patients was 32.31 years (17–76). Patients were more males (62.7%) than females (37.33%). Right lower quadrant pain was the most common symptom (100%) followed by anorexia (83.1), followed by nausea (68.7%) and vomiting (50%). The least common symptom was fever (15%). Tenderness in the RIF was the most common sign (95.2%). USG whole abdomen in 81.9% of patients was suggestive of acute appendicitis. The diagnosis was histopathologically confirmed in 53 cases (63.9%). Mean score of Alvarado score is 5.41. Mean score of AIR score is 4.96. And from these results, we derive that AIR has better diagnostic accuracy when compared to Alvarado score in predicting acute appendicitis.