Significance of The Modified Alvarado Score System in Diagnosis of Different Types of Acute Appendicitis in Adults_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 XUEWen-xiong ¹ , WANGHong ² , CHENBin ¹ , DONGZhi-yi ¹

1. Department of General Surgery, The First Hospital of Yulin, Yulin 718000, Shaanxi Province, China;
2. Department of Otorhinolaryngology, The First Hospital of Yulin, Yulin 718000, Shaanxi Province, China;

Corresponding author：

XUEWen-xiong, Email: xuewx1983@163.com

Keywords：

Modified Alvarado Score System; Acute appendicitis; Diagnostic significance

DOI：

10.7507/1007-9424.20140363

Video：

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Objective To study the diagnostic significance of modified Alvarado Score System for different types of acute appendicitis. Methods Clinical data of 1 930 cases of acute appendicitis, who underwent appendicectomy in The First Hospital of Yulin from Jan. 2004 to Jan. 2014, were retrospectively collected. Then the diagnostic significance of Modified Alvarado Score System was detected and evaluated by receiver operating characteristic (ROC) curve, and its correlation with postoperative pathological results was calculated. Results The modified Alvarado score of cases in progressive group was higher than that of simplex group (7.5±1.3 vs. 3.6±0.7, P < 0.001). The areas under ROC curve of modified Alvarado Score System was 0.943 (95% CI:0.929-0.958, P < 0.001). The critically diagnostic points of Modified Alvarado Score System for differential diagnosis of simplex acute appendicitis and progressive acute appendicitis was 6 score, with sensitivity of 92.9%, specificity of 86.3%, positive predictive value of 96.9%, negative predictive value of 72.6%, positive likelihood ratio of 6.8, negative likelihood ratio of 0.1, and Youden index of 91.7%. Conclusion This Modified Alvarado Score System has a certain significance for the type diagnosis of acute appendicitis.

Citation： XUEWen-xiong, WANGHong, CHENBin, DONGZhi-yi. Significance of The Modified Alvarado Score System in Diagnosis of Different Types of Acute Appendicitis in Adults. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(12): 1544-1547. doi: 10.7507/1007-9424.20140363 Copy

1.	Petroianu A.Diagnosis of acute appendicitis[J].Int J Surg, 2012, 10(3):115-119.
2.	张伟耀, 邓惠玲, 朱峰正, 等.急性阑尾炎CT检查的辅助诊断价值及鉴别诊断思路[J].中国普外基础与临床杂志, 2013, 20(12):1414-1416.
3.	Anderson JE, Bickler SW, Chang DC, et al.Examining a common disease with unknown etiology:trends in epidemiology and surgical management of appendicitis in California, 1995-2009[J].World J Surg, 2012, 36(12):2787-2794.
4.	Mán E, Simonka Z, Varga A, et al.Impact of the alvarado score on the diagnosis of acute appendicitis:comparing clinical judgment, alvarado score, and a new modified score in suspected appendicitis:a prospective, randomized clinical trial[J].Surg Endosc, 2014, 28(8):2398-2405.
5.	Raja AS, Wright C, Sodickson AD, et al.Negative appendectomy rate in the era of CT:an 18-year perspective[J].Radiology, 2010, 256(2):460-465.
6.	Alvarado A.A practical score for the early diagnosis of acute appendicitis[J].Ann Emerg Med, 1986, 15(5):557-564.
7.	Kalan M, Talbot D, Cunliffe WJ, et al.Evaluation of the modified Alvarado score in the diagnosis of acute appendicitis:a prospective study[J].Ann R Coll Surg Engl, 1994, 76(6):418-419.
8.	Ohle R, O'reilly F, O'brien KK, et al.The alvarado score for predicting acute appendicitis:a systematic review[J].BMC Med, 2011, 9:139.
9.	Kamran H, Naveed D, Asad S, et al.Evaluation of modified Alvarado score for frequency of negative appendicectomies[J].J Ayub Med Coll Abbottabad, 2012, 22(4):46-49.
10.	Nasiri S, Mohebbi F, Sodagari N, et al.Diagnostic values of ultrasound and the Modified Alvarado Scoring System in acute appendicitis[J].Int J Emerg Med, 2012, 5(1):26.
11.	Garg PK, Jain BK.Combined use of modified alvarado score and USG in decreasing negative appendicectomy rate:critical appra-isal of data[J].Indian J Surg, 2013, 75(3):227.
12.	Meltzer AC, Baumann BM, Chen EH, et al.Poor sensitivity of a modified Alvarado score in adults with suspected appendicitis[J].Ann Emerg Med, 2013, 62(2):126-131.
13.	Chan MY, Tan C, Chiu MT, et al.Alvarado score:an admission criterion in patients with right iliac fossa pain[J].Surgeon, 2003, 1(1):39-41.
14.	Pruekprasert P, Maipang T, Geater A, et al.Accuracy in diag-nosis of acute appendicitis by comparing serum C-reactive protein measurements, Alvarado score and clinical impression of surgeons[J].J Med Assoc Thai, 2004, 87(3):296-303.
15.	Abou Merhi B, Khalil M, Daoud N.Comparison of alvarado score evaluation and clinical judgment in acute appendicitis[J].Med Arh, 2014, 68(1):10-13.
16.	宋炜强, 赵海腾, 陈其民, 等.改良Alvarado评分系统与小儿阑尾炎术后病理的相关分析[J].中华小儿外科杂志, 2004, 25(2):14-15.
17.	Yildirim E, Karagülle E, Kirbaş I, et al.Alvarado scores and pain onset in relation to multislice CT findings in acute appendicitis[J].Diagn Interv Radiol, 2008, 14(1):14-18.
18.	郑树森.外科学[J].第2版.北京:高等教育出版社, 2011:482-490.
19.	Khan I, Ur Rehman A.Application of alvarado scoring system in diagnosis of acute appendicitis[J].J Ayub Med Coll Abbottabad, 2005, 17(3):41-44.
20.	Fente BG, Echem RC.Prospective evaluation of the Bengezi and Al-Fallouji modified Alvarado score for presumptive accurate diagnosis of acute appendicitis in University of Port Harcourt Tea-ching Hospital, Port Harcourt[J].Niger J Med, 2009, 18(4):398-401.
21.	Al-Hashemy AM, Seleem MI.Appraisal of the modified Alvarado Score for acute appendicits in adults[J].Saudi Med J, 2004, 25(9):1229-1231.
22.	孙振球.医学统计学[J].第3版.北京:人民卫生出版社, 2010:568-577.
23.	宋花玲.ROC曲线的评价研究及应用[D].上海:第二军医大学, 2006.
24.	Park SH, Goo JM, Jo CH.Receiver operating characteristic (ROC) curve:practical review for radiologists[J].Korean J Radiol, 2004, 5(1):11-18.
25.	段群欢, 唐朝晖, 卿伯华.入院时APACHEⅡ评分对重症急性胰腺炎发生深部真菌感染的判断价值[J].中国普外基础与临床杂志, 2012, 19(2):197-199.

1. Petroianu A.Diagnosis of acute appendicitis[J].Int J Surg, 2012, 10(3):115-119.
2. 张伟耀, 邓惠玲, 朱峰正, 等.急性阑尾炎CT检查的辅助诊断价值及鉴别诊断思路[J].中国普外基础与临床杂志, 2013, 20(12):1414-1416.
3. Anderson JE, Bickler SW, Chang DC, et al.Examining a common disease with unknown etiology:trends in epidemiology and surgical management of appendicitis in California, 1995-2009[J].World J Surg, 2012, 36(12):2787-2794.
4. Mán E, Simonka Z, Varga A, et al.Impact of the alvarado score on the diagnosis of acute appendicitis:comparing clinical judgment, alvarado score, and a new modified score in suspected appendicitis:a prospective, randomized clinical trial[J].Surg Endosc, 2014, 28(8):2398-2405.
5. Raja AS, Wright C, Sodickson AD, et al.Negative appendectomy rate in the era of CT:an 18-year perspective[J].Radiology, 2010, 256(2):460-465.
6. Alvarado A.A practical score for the early diagnosis of acute appendicitis[J].Ann Emerg Med, 1986, 15(5):557-564.
7. Kalan M, Talbot D, Cunliffe WJ, et al.Evaluation of the modified Alvarado score in the diagnosis of acute appendicitis:a prospective study[J].Ann R Coll Surg Engl, 1994, 76(6):418-419.
8. Ohle R, O'reilly F, O'brien KK, et al.The alvarado score for predicting acute appendicitis:a systematic review[J].BMC Med, 2011, 9:139.
9. Kamran H, Naveed D, Asad S, et al.Evaluation of modified Alvarado score for frequency of negative appendicectomies[J].J Ayub Med Coll Abbottabad, 2012, 22(4):46-49.
10. Nasiri S, Mohebbi F, Sodagari N, et al.Diagnostic values of ultrasound and the Modified Alvarado Scoring System in acute appendicitis[J].Int J Emerg Med, 2012, 5(1):26.
11. Garg PK, Jain BK.Combined use of modified alvarado score and USG in decreasing negative appendicectomy rate:critical appra-isal of data[J].Indian J Surg, 2013, 75(3):227.
12. Meltzer AC, Baumann BM, Chen EH, et al.Poor sensitivity of a modified Alvarado score in adults with suspected appendicitis[J].Ann Emerg Med, 2013, 62(2):126-131.
13. Chan MY, Tan C, Chiu MT, et al.Alvarado score:an admission criterion in patients with right iliac fossa pain[J].Surgeon, 2003, 1(1):39-41.
14. Pruekprasert P, Maipang T, Geater A, et al.Accuracy in diag-nosis of acute appendicitis by comparing serum C-reactive protein measurements, Alvarado score and clinical impression of surgeons[J].J Med Assoc Thai, 2004, 87(3):296-303.
15. Abou Merhi B, Khalil M, Daoud N.Comparison of alvarado score evaluation and clinical judgment in acute appendicitis[J].Med Arh, 2014, 68(1):10-13.
16. 宋炜强, 赵海腾, 陈其民, 等.改良Alvarado评分系统与小儿阑尾炎术后病理的相关分析[J].中华小儿外科杂志, 2004, 25(2):14-15.
17. Yildirim E, Karagülle E, Kirbaş I, et al.Alvarado scores and pain onset in relation to multislice CT findings in acute appendicitis[J].Diagn Interv Radiol, 2008, 14(1):14-18.
18. 郑树森.外科学[J].第2版.北京:高等教育出版社, 2011:482-490.
19. Khan I, Ur Rehman A.Application of alvarado scoring system in diagnosis of acute appendicitis[J].J Ayub Med Coll Abbottabad, 2005, 17(3):41-44.
20. Fente BG, Echem RC.Prospective evaluation of the Bengezi and Al-Fallouji modified Alvarado score for presumptive accurate diagnosis of acute appendicitis in University of Port Harcourt Tea-ching Hospital, Port Harcourt[J].Niger J Med, 2009, 18(4):398-401.
21. Al-Hashemy AM, Seleem MI.Appraisal of the modified Alvarado Score for acute appendicits in adults[J].Saudi Med J, 2004, 25(9):1229-1231.
22. 孙振球.医学统计学[J].第3版.北京:人民卫生出版社, 2010:568-577.
23. 宋花玲.ROC曲线的评价研究及应用[D].上海:第二军医大学, 2006.
24. Park SH, Goo JM, Jo CH.Receiver operating characteristic (ROC) curve:practical review for radiologists[J].Korean J Radiol, 2004, 5(1):11-18.
25. 段群欢, 唐朝晖, 卿伯华.入院时APACHEⅡ评分对重症急性胰腺炎发生深部真菌感染的判断价值[J].中国普外基础与临床杂志, 2012, 19(2):197-199.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Significance of The Modified Alvarado Score System in Diagnosis of Different Types of Acute Appendicitis in Adults

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