Comparative study of alvarado score and its modifications in the preoperative diagnosis of acute appendicitis at a tertiary center in Sokoto, Nigeria
Background: Decision-making in patients suspected of having acute appendicitis has remained a diagnostic challenge worldwide despite the advances in imaging and appendiceal surgery. There have been efforts to improve the diagnosis of appendicitis using clinical scoring systems. Aim: We evaluated and...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Nigerian Journal of Surgery |
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| Online Access: | http://www.nigerianjsurg.com/article.asp?issn=1117-6806;year=2020;volume=26;issue=1;spage=16;epage=21;aulast=Umar |
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| author | Muktar Muhammad Umar Ibrahim Umar Abubakar Stephen P Agbo |
| author_facet | Muktar Muhammad Umar Ibrahim Umar Abubakar Stephen P Agbo |
| author_sort | Muktar Muhammad Umar |
| collection | DOAJ |
| description | Background: Decision-making in patients suspected of having acute appendicitis has remained a diagnostic challenge worldwide despite the advances in imaging and appendiceal surgery. There have been efforts to improve the diagnosis of appendicitis using clinical scoring systems. Aim: We evaluated and compared the diagnostic accuracy and role of Alvarado score (AS) and two of its modification (Kalan and Al-Fallouji) in the preoperative diagnosis of acute appendicitis. Materials and Methods: This was a prospective study conducted at the Usmanu Danfodiyo University Teaching Hospital, Sokoto, of all adult patients operated for acute appendicitis from July 2014 to June 2017. The results were analyzed on computer using Statistical Package for the Social Science version 15.Results: One hundred and eleven patients were studied. Sixty-six (59.5%) patients were males and 45 (40.5%) were females. The male-to-female ratio was 1.5:1. The mean age was 23.89 ± 4.93 years. The AS sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 90.3%, 83.3%, 96.6%, 62.2%, and 89.2%, respectively, were similar to the findings of Kalan score (90.3%, 83.3%, 96.6%, 62.5%, and 89.2%, respectively) and Al-Fallouji score (96.8%, 66.7%, 93.8%, 80%, and 91.9%, respectively). The receiver operating curve and area under the curve show that Alvarado, Kalan, and Al-Fallouji are accurate scores in the preoperative diagnosis of acute appendicitis with an area under the curve of 0.88, 0.86, and 0.85, respectively. Conclusion: Kalan and Al-Fallouji scores have comparably good diagnostic accuracy as the AS among our patients. Any of these scores can be used as an adjunct in the preoperative diagnosis of acute appendicitis. |
| first_indexed | 2024-12-13T05:24:10Z |
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| institution | Directory Open Access Journal |
| issn | 1117-6806 |
| language | English |
| last_indexed | 2024-12-13T05:24:10Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Nigerian Journal of Surgery |
| spelling | doaj.art-301b8921445a408dadad72c11d1c1b4b2022-12-21T23:58:15ZengWolters Kluwer Medknow PublicationsNigerian Journal of Surgery1117-68062020-01-01261162110.4103/njs.NJS_46_19Comparative study of alvarado score and its modifications in the preoperative diagnosis of acute appendicitis at a tertiary center in Sokoto, NigeriaMuktar Muhammad UmarIbrahim Umar AbubakarStephen P AgboBackground: Decision-making in patients suspected of having acute appendicitis has remained a diagnostic challenge worldwide despite the advances in imaging and appendiceal surgery. There have been efforts to improve the diagnosis of appendicitis using clinical scoring systems. Aim: We evaluated and compared the diagnostic accuracy and role of Alvarado score (AS) and two of its modification (Kalan and Al-Fallouji) in the preoperative diagnosis of acute appendicitis. Materials and Methods: This was a prospective study conducted at the Usmanu Danfodiyo University Teaching Hospital, Sokoto, of all adult patients operated for acute appendicitis from July 2014 to June 2017. The results were analyzed on computer using Statistical Package for the Social Science version 15.Results: One hundred and eleven patients were studied. Sixty-six (59.5%) patients were males and 45 (40.5%) were females. The male-to-female ratio was 1.5:1. The mean age was 23.89 ± 4.93 years. The AS sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 90.3%, 83.3%, 96.6%, 62.2%, and 89.2%, respectively, were similar to the findings of Kalan score (90.3%, 83.3%, 96.6%, 62.5%, and 89.2%, respectively) and Al-Fallouji score (96.8%, 66.7%, 93.8%, 80%, and 91.9%, respectively). The receiver operating curve and area under the curve show that Alvarado, Kalan, and Al-Fallouji are accurate scores in the preoperative diagnosis of acute appendicitis with an area under the curve of 0.88, 0.86, and 0.85, respectively. Conclusion: Kalan and Al-Fallouji scores have comparably good diagnostic accuracy as the AS among our patients. Any of these scores can be used as an adjunct in the preoperative diagnosis of acute appendicitis.http://www.nigerianjsurg.com/article.asp?issn=1117-6806;year=2020;volume=26;issue=1;spage=16;epage=21;aulast=Umaracute appendicitisal-fallouji scorealvarado scoreappendicectomydiagnostic accuracykalan scoremodified alvarado scorenigeriasensitivityspecificity |
| spellingShingle | Muktar Muhammad Umar Ibrahim Umar Abubakar Stephen P Agbo Comparative study of alvarado score and its modifications in the preoperative diagnosis of acute appendicitis at a tertiary center in Sokoto, Nigeria Nigerian Journal of Surgery acute appendicitis al-fallouji score alvarado score appendicectomy diagnostic accuracy kalan score modified alvarado score nigeria sensitivity specificity |
| title | Comparative study of alvarado score and its modifications in the preoperative diagnosis of acute appendicitis at a tertiary center in Sokoto, Nigeria |
| title_full | Comparative study of alvarado score and its modifications in the preoperative diagnosis of acute appendicitis at a tertiary center in Sokoto, Nigeria |
| title_fullStr | Comparative study of alvarado score and its modifications in the preoperative diagnosis of acute appendicitis at a tertiary center in Sokoto, Nigeria |
| title_full_unstemmed | Comparative study of alvarado score and its modifications in the preoperative diagnosis of acute appendicitis at a tertiary center in Sokoto, Nigeria |
| title_short | Comparative study of alvarado score and its modifications in the preoperative diagnosis of acute appendicitis at a tertiary center in Sokoto, Nigeria |
| title_sort | comparative study of alvarado score and its modifications in the preoperative diagnosis of acute appendicitis at a tertiary center in sokoto nigeria |
| topic | acute appendicitis al-fallouji score alvarado score appendicectomy diagnostic accuracy kalan score modified alvarado score nigeria sensitivity specificity |
| url | http://www.nigerianjsurg.com/article.asp?issn=1117-6806;year=2020;volume=26;issue=1;spage=16;epage=21;aulast=Umar |
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