A Practical Score for the Early Diagnosis of Acute Appendicitis

A, Alvarado Durán

doi:10.1097/00006565-198609000-00017

Cited by 221 publications

(341 citation statements)

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“…Alvarado score (Table 1) This scoring system as described by Alvarado is based on three symptoms, three signs, two laboratory fi ndings [10].…”

Section: Methodsmentioning

confidence: 99%

“…6.06%, but positive USG can not be a prerequisite for appendicectomy as there is high false negative rate of 23.53% (Table 9). It can only complement clinical scores or Clinical scoring systems devised by Teicher et al [11], Alvarado [10], Lindberg and Fenyo [12], Ramirez and Dens [13], Galindo et al [14] had sensitivity ranging from 48 to 77% while specifi city of 73 to 87%, which is less than sensitivity of our diagnostic approach (97.14%) while specifi city is nearly same (Tables 5,6,7,8) In 1992, Owen et al [15] used Alvarado score prospectively and found negative appendicectomy rate of 6% in men, 22% in women and 12% in children, with overall negative appendicectomy rate of 12.6%. Kalan et al [16] using modifi ed version of Alvarado score found negative appendicectomy of 14.6%, sensitivity of 93% in males and 67% in females.…”

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confidence: 99%

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Combined use of modified Alvarado score and USG in decreasing negative appendicectomy rate

et al. 2010

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Introduction Appendicitis is notorious in its ability to simulate other conditions and in the frequency it can be mimicked by other pathologies. Despite extraordinary advances in modern radiography imaging and diagnostic laboratory investigations the accurate diagnosis of acute appendicitis remains an enigmatic challenge. Of the various commonly used diagnostic aids for appendicitis, no single test can reduce the rate of negative appendicectomy to zero.

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“…Alvarado score (Table 1) This scoring system as described by Alvarado is based on three symptoms, three signs, two laboratory fi ndings [10].…”

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Combined use of modified Alvarado score and USG in decreasing negative appendicectomy rate

et al. 2010

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“…Clinical examination has always been the forerunner to make the diagnosis of appendicitis [10]. But studies have shown a better outcome in the form of decreased negative appendectomy rates by using diagnostic scoring systems [11,12]. The Alvarado score is a 10 points scoring system for the diagnosis of appendicitis based on clinical signs and symptoms and a differential leukocyte count.…”

Section: Discussionmentioning

confidence: 99%

“…The Alvarado score is a 10 points scoring system for the diagnosis of appendicitis based on clinical signs and symptoms and a differential leukocyte count. In his original paper [11] Alvarado recommended an operation for all patients with a scores of 7 or more and observation for patients with scores of 5 or 6. Similarly imaging studies such as ultrasound have an average sensitivity and specificity of around 85-90% [13,14].…”

Section: Discussionmentioning

confidence: 99%

Clinically monitored delay-A valid option in cases with doubtful diagnosis of acute appendicitis

et al. 2010

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Aim To evaluate the effect of delayed surgery after a period of observation in patients with doubtful diagnosis of acute appendicitis in the form of improvement in negative appendectomy rates and the incidence of complications. Materials and methodsOne hundred twelve patients operated with the diagnosis of acute appendicitis between May 2008 to June 2009 were included in this retrospective study. They were divided into two groups based on timing of surgery after admission. These two groups were studied in respect to age, sex, Alvarado score at presentation, ultrasound findings, operative findings, histopathology and postoperative complications. Proportions of negative appendectomies, and complicated appendicitis were analysed statistically.Results Group wise age and sex distribution was comparable. The mean Alvarado score in the group 1 was 7.9 (range, 6-10) where as in those operated later than 12 hours (group 2), it was 4.5 (range, 3-8). Normal appendectomies were significantly (p < 0.05) less in group 2 (1 out of 40) as compared to group 1 (4 out of 72). The number of complicated appendicitis were higher in group 1 (14/72) as compared to group 2 (4/40) but not significantly (p > 0.06). The number of postoperative complications was also high in group 1 (11 vs 2 in group 2). ConclusionIt is better to wait in cases with doubtful initial diagnosis of appendicitis on admission in order to decrease negative appendectomy rates. These patients need to be continuously monitored clinically to prevent complications.

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“…Several methods for diagnosing acute appendicitis have been developed to increase the accuracy rate of diagnosis and to decease the negative appendectomy rate [4][5][6]. The initial method of diagnosing acute appendicitis have consisted of demographics, history, physical examination, and laboratory findings.…”

Section: Introductionmentioning

confidence: 99%

The Optimization Variables of Input Data of Artificial Neural Networks for Diagnosing Acute Appendicitis

Park¹,

Kim²

2014

Appl. Math. Inf. Sci.

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Abstract:The purpose of this study is to suggest an efficient diagnosis system for acute appendicitis using the artificial neural network model with optimized input variables. Acute appendicitis is one of the most common diseases of the abdomen. However, the accuracy of diagnosis is not high even with experienced surgeons due to its complex symptoms. We used the artificial neural networks model to analyze the complex problems. A total of 801 suspected acute appendicitis patients were collected and a multilayer neural network with thirteen input variables, and two hidden layers with thirty neurons were used to diagnosis acute appendicitis. The mean-square error (0.0011) was stabilized after seven input variables. The nine to thirteen input variables had a high and equal performance (98.81%, 100%, 98.39%, 100%, 99.31%, and 0.995 for specificity, sensitivity, positive predictive value, negative predictive value, accuracy and AUC, respectively). We had optimized the input variables and the performance is significantly higher than the published diagnosis method such as the Alvarado clinical scoring system. We believe that the developed model regarding the multilayer neural network would be a useful method to rapidly and correctly diagnosis acute appendicitis for clinical surgeons.

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A Practical Score for the Early Diagnosis of Acute Appendicitis

Cited by 221 publications

References 0 publications

Combined use of modified Alvarado score and USG in decreasing negative appendicectomy rate

Combined use of modified Alvarado score and USG in decreasing negative appendicectomy rate

Clinically monitored delay-A valid option in cases with doubtful diagnosis of acute appendicitis

The Optimization Variables of Input Data of Artificial Neural Networks for Diagnosing Acute Appendicitis

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