Comparison Between Alvarado Score and Paediatric Appendicitis Score in Diagnosing Acute Appendicitis in Children

Authors

  • Bikesh Rajbhandari Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
  • Geha Raj Dahal Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
  • Rameshwar Prasad Pokharel Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal

DOI:

https://doi.org/10.3126/jnps.v40i3.29288

Keywords:

Acute appendicitis, Alvarado score, Pediatric appendicitis score

Abstract

Introduction: Acute appendicitis is the most common atraumatic surgical emergency in childhood. The accurate diagnosis of acute appendicitis is not always easy. Alvarado score (AS) and paediatric appendicitis score (PAS) are commonly used tools to assist diagnosis. This study compares the diagnostic accuracy between AS and PAS.

Methods: A prospective study was conducted from September 2016 to September 2017 in Paediatric Surgery Unit of Tribhuvan University Teaching Hospital. All eligible patients (children up to 16 years) who were operated for acute appendicitis were included. AS and PAS were calculated for all patients preoperatively. Final diagnosis of acute appendicitis was based on histopathological examination and labeled as ‘appendicitis’ or ‘no appendicitis’. A cut off score of 7 for AS and 6 for PAS was compared with ‘appendicitis’ or ‘no appendicitis’ group.

Results: A total of 70 patients were included in the study. Sixty five (93%) were histologically proven acute appendicitis and five (7%) were no appendicitis. The sensitivity, specificity, PPV, NPV and accuracy of AS were 89%, 40%, 95%, 22% and 85% respectively. For PAS, sensitivity, specificity, PPV, NPV and accuracy was 97%, 40%, 95.5%, 50% and 92% respectively. On Receiver Operating Characteristic curve, ‘area under curve’ of AS was 0.64 and that of PAS was 0.84. It was not statistically significant (p = 0.152).

Conclusions: There was no statistical significant difference between AS and PAS for diagnosing acute appendicitis.

Downloads

Download data is not yet available.
Abstract
400
PDF
391

Author Biographies

Bikesh Rajbhandari, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal

Paediatric Surgery Unit, Department of General Surgery

Geha Raj Dahal, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal

Associate Professor, Paediatric Surgery Unit, Department of General Surgery

Rameshwar Prasad Pokharel, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal

Paediatric Surgery Unit, Department of General Surgery

Cover JNPS

Downloads

Published

2020-12-15

How to Cite

Rajbhandari, B., Dahal, G. R., & Pokharel, R. P. (2020). Comparison Between Alvarado Score and Paediatric Appendicitis Score in Diagnosing Acute Appendicitis in Children. Journal of Nepal Paediatric Society, 40(3), 178–184. https://doi.org/10.3126/jnps.v40i3.29288

Issue

Vol. 40 No. 3 (2020)

Section

Original Articles

License

Authors who publish with this journal agree to the following terms:

Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).