Ultrasonography and the Alvarado score in the diagnosis of acute appendicitis: impact on the negative appendectomy rate
Genzor Ríos SJ, Rodríguez Artigas JM, Giménez Maurel T, Vallejo Bernad C, Aguirre Prat N, Miguelena Bobadilla JM
Affiliation of the authors
Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, Spain. Departamento de Cirugía, Obstetricia y Ginecología, Universidad de Zaragoza, Zaragoza, Spain.
Genzor Ríos SJ, Rodríguez Artigas JM, Giménez Maurel T, Vallejo Bernad C, Aguirre Prat N, Miguelena Bobadilla JM. Ultrasonography and the Alvarado score in the diagnosis of acute appendicitis: impact on the negative appendectomy rate. Emergencias. 2016;28:396-9
To establish the negative appendectomy rate (NAR) after patients with acute abdomen were evaluated with the Alvarado score and compare it to the NAR in patients evaluated with abdominal ultrasound.
Methods.
Cross-sectional, retrospective, descriptive study in patients who underwent emergency surgery for suspected acute appendicitis in a tertiary-care hospital over a period of 1 year.
Results.
A total of 225 patients were included. The NAR was 7.11% for the series. An Alvarado score of 5 or more had an odds ratio (OR) of 7.46 (P=.0002) for acute appendicitis; sensitivity was 94.2%. Ultrasound findings consistent with acute appendicitis had an OR of 3.58 (P=.0125) for the diagnosis; the NAR was 5%.
Conclusions.
The high sensitivity of an Alvarado score of 5 or more supports using this tool to evaluate all patients who come to the emergency department with pain in the right iliac fossa. With scores of 7 or more the NAR falls to 3%. Abdominal ultrasound is a rapid, inexpensive diagnostic procedure associated with a low NAR.
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