Limpawattanasiri Chairoek
Division of Surgery, Chachoengsao Hospital, Chachoengsao, Thailand.
J Med Assoc Thai. 2011 Apr;94(4):441-9.
To assess the accuracy of Alvarado Score in predicting acute appendicitis in Chachoengsao Hospital.
The prospective study involved 1, 000 patients with suspected acute appendicitis. It was carried out between April 2008 and March 2010. The patients were given specific scores according to variables of Alvarado Scoring System. The signs, symptoms, laboratory values and pathology reports of each patient were collected and evaluated. The diagnosis was confirmed by operative findings and histopathological examination of specimens. The sensitivity, specificity, positive and negative predictive values and receiver operator characteristic (ROC) curves of each indicator were also calculated.
Out of total 1,000 patients (407 males, 593 females), 838 underwent surgery (352 males, 486 females) and specimens of 715 patients (313 males, 402 females) were confirmed by histopathological examination, thus giving negative appendectomy rate of 14.7% (11.08% males, 17.28% females). The overall sensitivity of Alvarado Score was 87.41% and the specificity was 74.39%, while the positive predictive value was 83.7%. The area under the curve was 0.74.
Though the diagnosis of acute appendicitis remains mainly clinical evaluation, Alvarado Score can be recommended as a helpful tool for the admission criteria and further management in order to reduce unnecessary admission, morbidity and mortality, length of stay, and cost of treatment.
评估阿尔瓦拉多评分在猜也奔府医院预测急性阑尾炎方面的准确性。
这项前瞻性研究纳入了1000例疑似急性阑尾炎患者。研究于2008年4月至2010年3月期间进行。根据阿尔瓦拉多评分系统的变量给患者赋予特定分数。收集并评估每位患者的体征、症状、实验室值和病理报告。通过手术所见和标本的组织病理学检查来确诊。还计算了每个指标的敏感性、特异性、阳性和阴性预测值以及受试者工作特征（ROC）曲线。
在总共1000例患者（407例男性，593例女性）中，838例接受了手术（352例男性，486例女性），715例患者（313例男性，402例女性）的标本经组织病理学检查确诊，因此阴性阑尾切除率为14.7%（男性为11.08%，女性为17.28%）。阿尔瓦拉多评分的总体敏感性为87.41%，特异性为74.39%，而阳性预测值为83.7%。曲线下面积为0.74。
虽然急性阑尾炎的诊断仍主要依靠临床评估，但阿尔瓦拉多评分可作为入院标准和进一步管理的有用工具，以减少不必要的入院、发病率和死亡率、住院时间以及治疗费用。
