The Alvarado scoring system in acute appendicitis: A 6-month cross-sectional study to evaluate its reliability in reducing the rate of negative appendicectomy at Queen’s Hospital, Burton

2017 ◽  
Vol 2 (0) ◽  
pp. 32
Author(s):  
Joshua Agilinko ◽  
Naseem Waraich
Keyword(s):  
Acute Appendicitis ◽  
Scoring System ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Negative Appendicectomy

scholarly journals Modified Alvarado scoring system as a diagnostic tool for acute appendicitis at a tertiary care teaching hospital, Central India: a cross sectional study

2017 ◽  
Vol 4 (8) ◽  
pp. 2439
Author(s):  
Dilip Kothari ◽  
Archana Kothari ◽  
Abhishek Kalantri ◽  
Pawan Bhambani
Keyword(s):  
Acute Appendicitis ◽  
Scoring System ◽  
Tertiary Care ◽  
False Negative ◽  
Cross Sectional Study ◽  
General Information ◽  
Human Beings ◽  
Sectional Study ◽  
Cross Sectional ◽  
Negative Appendicectomy

Background: Acute Appendicitis forms an important emergency in the day-to-day surgical practice. It affects human beings irrespective of age, nationality and religion. Early diagnosis and prompt operative intervention is the key for successful management of acute appendicitis. However, the picture of acute appendicitis may not be classical, and in such situations, a policy of early intervention to avoid perforation may lead to high negative appendicectomy rates.Methods: A total of 80 patients were enrolled in the present cross sectional study. Their ages ranged from eleven to 72 years (mean 32.89 ± 15.87). A proforma containing general information about the patient plus eight variables based on the modified Alvarado scoring system was filled.Results: Histological examination confirmed appendicitis in 54 patients (67.5%). The remaining 26 patients were found to have normal appendix giving a negative appendicectomy rate of 32.5% being 36.8% and 28.3% for males and females respectively.Conclusions: This scoring system is easy, simple and cheap complementary aid for supporting the diagnosis of acute appendicitis. MASS can be used effectively in Indian setup to reduce the incidence of negative appendectomies. The patients are not unduly exposed to risks of delay in intervention or significant increase in number of false negative cases.

scholarly journals Diagnostic efficacy of Fenyo-Lindberg scoring system in patients of acute appendicitis a one-year cross sectional study

2020 ◽  
Vol 7 (12) ◽  
pp. 3998
Author(s):  
Kartik Sahu ◽  
Anil P. Bellad
Keyword(s):  
Acute Appendicitis ◽  
Sample Size ◽  
Scoring System ◽  
Cross Sectional Study ◽  
Histopathological Diagnosis ◽  
Sectional Study ◽  
Diagnostic Efficacy ◽  
Cross Sectional ◽  
Group I ◽  
One Year

Background: Diagnostic scores have been found to be very efficient. The present study was taken up to calculate diagnostic efficacy of Fenyo-Lindberg (FL) scoring system in patients of acute appendicitis.Methods: A one-year cross sectional study was done on 100 patients in patients with right lower quadrant pain. Group I had patients with score of -2 and above and group II with score below -2. The groups were compared with histopathological diagnosis. Then, the sensitivity, specificity, positive predictable value (PPV) and negative predictable value (NPV) were calculated.Results: In this study, the males were 52 and females were 48.15 patients, Total leucocyte count (TLC) had more than 14,000 whereas 16 patients had onset of pain in less than 24 hours. 47 patients had vomiting. Tenderness was present in all cases, while rebound tenderness was present in 54% of cases. 98% of patients had progression of pain, whereas migration was seen in 76%. 56% patients had increased pain on coughing. 54 patients had acute appendicitis on histopathology. The study shows that this scoring system has sensitivity of 72% and specificity of 71% in diagnosing acute appendicitis. The PPV was 75% and NPV was 68%.Conclusions: The FL score is an inexpensive clinical tool that may help the diagnosis of acute appendicitis. The results are comparable to previous studies but as the sample size is small, study has to be done in higher sample size to get the data necessary to generalize the findings and the fact that this study was first on this scoring system in India should also be considered.

scholarly journals Use and relevance of modified alvarado scoring system in diagnosis of acute appendicitis: a cross sectional study from West Bengal, India

2019 ◽  
Vol 6 (2) ◽  
pp. 346
Author(s):  
Malay K. Barman ◽  
Mahua Chanak ◽  
Kaustav Das ◽  
Koel Mukherjee
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Acute Appendicitis ◽  
Scoring System ◽  
West Bengal ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Remote Areas ◽  
Primary Health

Background: For successful management of acute appendicitis, early diagnosis and intervention is needed. Incorrect diagnosis may allow significantly increased morbidity and mortality. Several studies across the globe shows that Modified Alvarado Scoring System (MASS) does not need high end instrument and can be done in emergency situation for accessing acute appendicitis and reducing the chances of unnecessary surgery. To access the efficacy of MASS for diagnosis of acute appendicitis in remote areas with primary health care facilities, present study was done at Siliguri of Darjeeling district of West Bengal which was 580 km distant from state capital (Kolkata).Methods: A cross sectional study over a period of 16 months was conducted among the patients admitted at North Bengal Medical College and Hospital suspected to have acute appendicitis. The diagnosis was confirmed by histopathological examination. Written consent was obtained from the patients before commencement of the study. MASS was applied to the patients and the results were compared with histopathological findings. Appropriate statistical analysis has been done by SPSS (version 16.0).Results: A total of 75 patients (44 males and 31 females) were considered. The sensitivity and specificity of MASS in this study were 75.86% (71.43% for males and 80% for females) and 82.61% (80% for males and 87.5% for females) respectively. Study revealed statistically significant (p<0.000) association between Histopathological report and MASS.Conclusions: To reduce the chances of negative appendectomy and for better diagnosis of appendicitis, MASS may be more useful at primary health care centres those are located in remote areas as it was very simple, easy and cost effective.

scholarly journals A Cross-Sectional Study of Neutrophil-to-Lymphocyte Ratio in Diagnosing Acute Appendicitis in Hospital Melaka

2019 ◽  
Vol 26 (6) ◽  
pp. 55-66
Author(s):  
Khairol Ashraf Ahmad ◽  
◽  
Noorharisman Ideris ◽  
Syed Hassan Syed Abd Aziz ◽  
◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Cross Sectional Study ◽  
Neutrophil To Lymphocyte Ratio ◽  
Sectional Study ◽  
Cross Sectional ◽  
Lymphocyte Ratio

Appendicoliths: the neglected stones

2017 ◽  
Vol 4 (1) ◽  
pp. 3-6
Author(s):  
Saroj Dhital ◽  
Udaya Koirala ◽  
Birendra Dhoj Joshi ◽  
Amit Mani Upadhyaya ◽  
Arbin Joshi
Keyword(s):  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Vermiform Appendix ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Recurrent Appendicitis ◽  
Right Iliac Fossa Pain

Introductions: Cases of colic of the vermiform appendix have been rarely described or diagnosed. Appendicoliths cause acute appendicitis and appendicular perforation. It is still not clear whether appendicoliths cause appendicular colic in the absence of acute appendicitis. Methods: A cross sectional study that included appendectomy done for recurrent appendicitis or chronic right iliac fossa pain. Histology reports were reviewed. The presence of an appendicolith in the report was noted. Results: Thirty-two cases of recurrent appendicitis and chronic right iliac fossa pain were included. Twenty-four patients (75%) had fecoliths in the histology specimens. Eight patients (25%) who presented with appendicular colic without signs of appendicitis were further evaluated. Conclusions: Majority of patients with chronic or colicky right iliac fossa pain had appendicoliths.

scholarly journals Prevalence of perforated appendicitis and its determinants in pediatric appendicitis patients admitted in tertiary care centre, South India: a cross sectional study

2018 ◽  
Vol 5 (12) ◽  
pp. 3926
Author(s):  
Chandrashekar S. ◽  
Lokesh M. G. ◽  
Avinash S. R.
Keyword(s):  
Acute Appendicitis ◽  
Tertiary Care ◽  
Perforated Appendicitis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Alvarado Score ◽  
Cross Sectional ◽  
Pediatric Age Group ◽  
Perforated Appendix

Background: Appendicitis remains a common indication for urgent surgical intervention in pediatric age group. Acute appendicitis has the highest incidence during the second decade of life. When the diagnosis is performed, perforation could be already present in 30%-75% of children, with young children being at higher risk. The challenge for the practitioner is to perform a timely diagnosis of acute appendicitis in first years of life before complications occur.Methods: A facility based cross sectional study was conducted with sample size of 108. The patients diagnosed and operated for acute appendicitis using Alvarado score were correlated with intra operative findings.Results: Total 108 patients with median age of 11 (IQR 9–13) years, were included in the study in which 66% were male. Overall 18% (95% CI 11%-25%) had perforated appendix and 5% (95% CI 2%-11%) had appendicitis with abscess. Male gender, patients presenting with fever, guarding, rigidity and patients presenting 48 hours after developing symptoms, had higher chance of perforation. Mean count of WBC (17000 v/s 11000) and neutrophils (75% v/s 68%) were found to be higher in patients with perforated appendicitis.Conclusions: One-fifth of the pediatric appendicitis patients presenting in tertiary care patients had perforated appendicitis.

scholarly journals A comparison of Tzanakis and Alvarado scoring system in the diagnosis of acute appendicitis

2019 ◽  
Vol 6 (6) ◽  
pp. 2080
Author(s):  
R. Anupriya ◽  
C. P. Ganesh Babu ◽  
K. V. Rajan
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Scoring System ◽  
Histopathological Examination ◽  
Cross Sectional Study ◽  
Alvarado Score ◽  
Cross Sectional ◽  
Abdominal Emergency ◽  
Gandhi Medical College ◽  
Research Institute Hospital

Background: Appendicitis is the most common abdominal emergency worldwide. Lifetime risk of acute appendicitis is 8.6% and 6.7% for man and women respectively. Clinical examination is helpful in diagnosis of acute appendicitis in only 70-87% of the cases. To compare Tzanaki and Alvarado scoring system in diagnosing acute appendicitis.Methods: This was a prospective, comparative, cross-sectional study, which was conducted at the Mahatma Gandhi Medical College and Research Institute Hospital. Patients with acute appendicitis were included in the study. Relevant history, examination and laboratory investigations done. Patients were scored according to both Alvarado scoring system and Tzanakis scoring, and both were documented in the proforma. Sensitivity, specificity, positive predictive value, negative predictive value were assessed and compared for both scoring systems.Results: 70 patients were included in this study. 54.3% of patients have Tzanakis score more than 8. 35.7% of patients have Alvarado score more than 7. 82.9% of patients had evidence of appendicitis in histopathological examination. Tzanakis score: sensitivity– 65.52%, specificity- 100%, PPV–  100%, NPV– 37.50%, accuracy– 71.43%. Alvarado score: sensitivity– 36.21%, specificity– 66.67%, PPV- 84%, NPV– 17.78%, accuracy– 41.43%.Conclusions: Tzanakis scoring system is an effective scoring system in diagnosing acute appendicitis.

scholarly journals Clinical symptoms, paraclinical tests and histopathological results in children with acute appendicitis in Zabol southeast of Iran: a cross-sectional study

2017 ◽  
Vol 5 (7) ◽  
pp. 2836
Author(s):  
Mehran Hesaraki
Keyword(s):  
Acute Appendicitis ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Intestinal Loop ◽  
Negative Appendectomy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms ◽  
Histopathological Results

Background: This article aimed to assessment clinical signs and symptoms, paraclinical tests and histopathological results in children with acute appendicitis.Methods: A cross-sectional study conducted on 100 children with acute appendicitis in an urban hospital in southeast of Iran from January to December 2016. Participants were selected by simple random sampling method. Clinical signs and symptoms, paraclinical tests and histopathological results recorded in checklists. The data were analyzed using SPSS 22.Results: Mean age of the patients was 10.26±3.25, fourthly-eight of patients (58.5%) were males and 34 patients (41.5%) were females. The most frequent clinical signs and symptoms were acute suppurative appendicitis with peri appendicitis (45.83%) and acute suppurative appendicitis (39.58%). The most frequent results in ultrasound reports were Intestinal loop thickness greater than 6 mm without peristalsis (positive report) (46.34%) and Invisible appendix (nega Hesaraki tive report) (13.41%).Conclusions: The results of this study showed that abdominal pain and RLQ tenderness were the most common signs and symptoms and WBC left-shift was the most common laboratory finding. Since the rate of negative appendectomy in this study was consistent with surgical results and other articles, it is concluded that diagnostic accuracy of preoperative appendectomy was acceptable and most children with acute appendicitis underwent appendectomy.

scholarly journals Enthesopathy and involvement of synovio-entheseal complex in systemic sclerosis: an ultrasound pilot study

Rheumatology ◽  
2019 ◽  
Author(s):  
Riccardo Terenzi ◽  
Rositsa Karalilova ◽  
Gemma Lepri ◽  
Cosimo Bruni ◽  
Silvia Bellando-Randone ◽  
...  
Keyword(s):  
Scoring System ◽  
Healthy Subjects ◽  
Power Doppler ◽  
Cross Sectional Study ◽  
Interquartile Range ◽  
Sectional Study ◽  
Internal Organs ◽  
Cross Sectional ◽  
Cortical Irregularity ◽  
Chronic Autoimmune Disease

Abstract Objectives SSc is a chronic autoimmune disease characterized by inflammation of the skin and multiple internal organs. Articular involvement is one of the main features of SSc, and typical hallmarks of SpA have been found in SSc patients. The aim of the present study was to estimate the prevalence of entheseal and synovio-entheseal complex (SEC) alterations in a cohort of SSc patients. Methods One hundred SSc patients and 25 healthy subjects were included in this cross-sectional study. The enthesis sites of lateral epicondylar common extensor tendons (CET) and the enthesis of the Glasgow Ultrasound Enthesis Scoring System were evaluated. SEC involvement was evaluated only at CET enthesis. Results In SSc, the Glasgow Ultrasound Enthesis Scoring System score was significantly higher (median 4.0, interquartile range 2.0–7.0) than in controls (median 1.0, interquartile range 0.0–3.0) (P < 0.0001). CET enthesis of SSc patients showed more frequent US B-mode alterations than that of controls (χ2 = 11.47, P = 0.0007 for size; χ2 = 13.79, P = 0.0002 for cortical irregularity, χ2 = 5.24, P = 0.022 for calcification/enthesophytes). Power Doppler US signal at CET enthesis was significantly more frequent in SSc patients than in healthy controls (χ2 = 9.11, P = 0.0025), as was the concomitant SEC involvement (χ2 = 8.52, P = 0.0035). Conclusion These data show that SSc patients frequently present US features of enthesopathy. Moreover, CET enthesopathy was correlated with SEC inflammation, suggesting that entheseal inflammation in SSc may share the same micro-anatomical targets as found in SpA.

Sign in / Sign up

Export Citation Format

Share Document