Diagnostic Accuracy of Modified Alvarado Scoring System in Acute Appendicitis in the Egyptian Patients

Abstract Background Approximately 7% of population will suffer from acute appendicitis during their life time. In 1889 Mc Burney in New York pioneered early diagnosis of appendicitis and was the first to point out the importance of early surgical intervention. Objective To assess the diagnostic accuracy of modified Alvarado scoring system in acute appendicitis in the Egyptian patients correlated with the operative findings and histo-pathological results. Patients and Methods This was a prospective; was conducted in Ain Shams University Hospitals and Nasr City Police Hospital, over a period of 6 Months, from February 2019 to August 2019, the study was carried out on 40 cases of both genders presenting to the emergency department with suspected acute appendicitis. Results There was statistically significant association between Histo-pathological findings and MASS (p < 0.001). There was statistically significant association between MASS and US findings (p < 0.001). Modified Alvarado Scoring System (MASS) showed a very high diagnostic value (AUC = 0.84, specificity = 88.6%, sensitivity = 80%, PPV=96.9%, NPV=50.0%, p-value =0.0001. Conclusion The present study has shown that MASS provides high degree of sensitivity, specificity, PPV, NPV and accuracy in the diagnosis of acute appendicitis, Alvarado scoring system increases the sensitivity and specificity for diagnosis of acute appendicitis with the added advantages of being simple and easy to use. Moreover it is repeatable at no cost. Thus the application of this scoring system improves diagnostic accuracy and consequently reduces appendicectomy.