Özsoy Zeki, Yenidoğan Erdinç
Department of General Surgery, Gaziosmanpaşa University School of Medicine, Tokat, Turkey.
Turk J Surg. 2017 Sep 1;33(3):200-204. doi: 10.5152/turkjsurg.2017.3539. eCollection 2017.
In this study, we aimed to show the effectiveness of Alvarado score and its components to predict the correct diagnosis of acute appendicitis and to find an optimum cut-off value for Alvarado score.
The patients who underwent surgical operation between January 2011 and January 2012 with the suspicion of acute appendicitis were included in the study. Their demographic and clinical features and histopathological results were retrieved from the medical records. They were divided into three groups according to their Alvarado scores. With the use of "receiver operating characteristic" curve analysis, the optimum cut-off value needed to make a correct diagnosis of acute appendicitis was determined.
In all, 156 patients were included into the study. The mean age was 31.41±13.27 years. Histopathologically, acute appendicitis was detected in 125 (80.1%) patients, and negative appendectomy was found in 31 patients (19.8%). Mean Alvarado score was 6.44±1.49. There was a significant correlation between negative appendectomy and low Alvarado score (p<0.001). The main component of Alvarado score that makes the difference was rebound. Fever higher than 37.3°C, rebound, loss of appetite, and existence of shifting pain were statistically differential components (p=0.042, p<0.001, p=0.045, p<0.001, respectively). The rate of correct diagnosis of acute appendicitis was maximum in group 3 (100%) and minimum in group 1 (21.7%). Optimum cut-off value for Alvarado score was 7.
Patients with an Alvarado score of over 7 can be taken into surgical operation without the need of imaging methods.
在本研究中，我们旨在展示阿尔瓦拉多评分及其各组成部分在预测急性阑尾炎正确诊断方面的有效性，并找到阿尔瓦拉多评分的最佳临界值。
纳入2011年1月至2012年1月期间因疑似急性阑尾炎而接受手术的患者。从病历中获取他们的人口统计学和临床特征以及组织病理学结果。根据阿尔瓦拉多评分将他们分为三组。通过“受试者工作特征”曲线分析，确定急性阑尾炎正确诊断所需的最佳临界值。
总共156名患者纳入研究。平均年龄为31.41±13.27岁。组织病理学检查发现，125例（80.1%）患者为急性阑尾炎，31例（19.8%）患者为阴性阑尾切除术。阿尔瓦拉多评分的平均值为6.44±1.49。阴性阑尾切除术与低阿尔瓦拉多评分之间存在显著相关性（p<0.001）。造成差异的阿尔瓦拉多评分的主要组成部分是反跳痛。体温高于37.3°C、反跳痛、食欲不振和转移性疼痛的存在在统计学上是有差异的组成部分（分别为p=0.042、p<0.001、p=0.045、p<0.001）。急性阑尾炎的正确诊断率在第3组最高（100%），在第1组最低（21.7%）。阿尔瓦拉多评分的最佳临界值为7。
阿尔瓦拉多评分超过7分的患者无需影像学检查即可进行手术。
