Importance of Alvarado scoring system in diagnosing Acute Appendicitis

Umair Hashmi, Khadija Nadeem, Qudsia Zafar, Fatima Zartaj


OBJECTIVE: One of the most common emergencies in surgical wards is acute appendicitis. Appendicitis can be diagnosed by different scoring systems . This study has objective to know the accuracy of Alvarado Scoring system to diagnose acute appendicitis.

DESIGN: Descriptive case series

SETTING: surgical ward-4, Bahawal Victoria Hospital Bahawalpur, Punjab – Pakistan; from January 2016 to March 2017.

METHODS:  All the patients with the suspicion of acute appendicitis were admitted in the surgical ward. A proforma was made with relevant findings written on it. The change in the initial score according to Alvarado Scoring System was documented at the time of admission regarding increase or decrease of severity of symptoms. On the basis of change in the score, decision of surgical intervention was made. 

RESULTS:  A total of 220 patients with suspicion of acute appendicitis were admitted in the ward. Among them, 150 (68.18%) were males and 70 (31.80%) patients were females. Age ranged from12-62 years. Main symptoms at presentation included fever (60%), pain in right iliac fossa (65.4%) and nausea and vomiting (45.32%). Thirty patients were received with Alvarado Score of 1-4 and two out of them required surgery. Forty were in the score of 5, twenty-five out of them required surgery. 150 patients were in the score of 6 and all of them required surgery. Out of 177 patients who underwent surgery, 170 had appendicitis. The rate of negative appendectomy was 3.95%

CONCLUSION:  This study concluded that the patients having score up to 4 according to Alvarado probably do not need surgical intervention and the patients having score up to 5, maximum patients in this range need emergency surgery but those having score 6 and above, they all will need surgery.


Appendicectomy. Appendicitis. Alvarado scoring system.

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