Objective: To determine the association between Alvarado score and the severity of acute appendicitis in an East Coast Hospital, Malaysia. Methods: The cross-sectional study involved reviewing the record of all 177 Patients operated for suspected acute appendicitis in the hospital. Data were collected using a proforma. The severity of appendicitis was divided into perforated or non-perforated from the histo-pathological examination reports. Alvarado score recorded during the presentation to hospital was recorded. Simple and multiple logistic regression analysis were used to determine the association between Alvarado score and the severity of acute appendicitis. Results: Prevalence of perforated appendicitis was 25.1%. The mean of Alvarado score was 7.5 (SD: 1.35). Multiple logistic regression analysis showed a significant association between Alvarado score and severity of acute appendicitis after adjusting for age, gender and duration of pain before presentation. Conclusion: Higher Alvarado score is associated with higher odds of perforation. Therefore, Alvarado score could be used not just for diagnostic purpose, but also for predicting the severity of appendicitis.

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