Clinical study of correlation between modified Alvarado scoring system (MASS) and acute appendicitis

Dr.L.Premalatha; Dr.P.Shanthini; Dr.T.Aravind; Dr.Divyalakshmi

Volume : VI, Issue : X, October - 2017

Clinical study of correlation between modified Alvarado scoring system (MASS) and acute appendicitis

Dr. L. Premalatha, Dr. P. Shanthini, Dr. T. Aravind, Dr. Divyalakshmi

Abstract :

BACKGROUND:Decision–making in patients with acute appendicitis poses a diagnostic challenge worldwide, despite much advancement in surgery. The Modified Alvarado Scoring System (MASS) has been reported to be a cheap and quick diagnostic tool in patients with acute appendicitis.

AIM OF THE STUDY: The purpose of this study was to evaluate the diagnostic value of Modified Alvarado Scoring System in patients with acute appendicitis in our setting.

MATERIALS AND METHODS:A cross–sectional study involving all patients suspected to have acute appendicitis at KAPV Govt. Medical College Trichy over a six–month period between January 2017 and july 2017 was conducted. They were evaluated on admission using the MASS to determine whether they had acute appendicitis or not. All patients underwent appendicectomy according to the hospital protocol. The decision to operate was the prerogative of the surgeon or surgical resident based on overall clinical judgment and not the MASS. Factors were tabulated and analyzed statistically

RESULTS:A total number of 85 patients were studied. Their ages ranged from nine to 65 years. There were 51 (60%) males and 34 (40%) females (M: F = 1.5:1). All patients in this study underwent appendicectomy. The perforation rate was 9.4%. Histopathological examination confirmed appendicitis in 67 patients (78.8%) and the remaining 18 patients had normal appendix giving a negative appendicectomy rate of 21.17%. The sensitivity and specificity of MASS in this study were 91.1% and 83.3% respectively. The Positive Predictive Value and Negative Predictive Value were 95.3% and 71.42% respectively.

CONCLUSION:The study shows that use of MASS in patients suspected to have acute appendicitis provides a high degree of diagnostic accuracy and subsequently reduces negative appendicectomy and complication rates. However, additional investigations may be required to confirm the diagnosis in case of atypical presentation.