Revista Colombiana de Cirugía
Print version ISSN 2011-7582
OSPINA, Juan Manuel; BARRERA, Lina Fernanda and MANRIQUE, Fred Gustavo. Utility of a diagnostic scale scoring system in acute appendicitis. rev. colomb. cir. [online]. 2011, vol.26, n.4, pp. 234-241. ISSN 2011-7582.
Objective. To assess the Alvarado's diagnosis scores in a series of patients undergoing surgery with diagnosis of acute appendicitis. Materials and Methods. Descriptive, cross sectional study. The medical records of 101 cases that underwent surgery with diagnosis of acute appendicitis at Duitama's Regional Hospital, Duitama, Colombia, during the period January to March of 2010 were reviewed. The scores of the Alvarado's diagnostic scale were correlated with the histopathological results, time evolved before diagnosis, gender and age of the patient. Results. There were 56.6% male and 65.4% of patients were less than 30 years of age, median time evolved before diagnosis was 44.6 hours. Positive association was found between evolved time over 36 hours before diagnosis and necrosis of the appendix (p <0.01). Correlation of the diagnostic Alvarado score and histopathologic findings was 75.2%. The criteria that showed higher discriminating capacity were abdominal pain localized in the lower right quadrant, migration of pain, Blumberg´s sign, leukocytosis and neutrophilia (p <0.001); less discriminatory power were nausea/vomiting, fever, and anorexia. Conclusion. The Alvarado's diagnosis score, can be a very useful diagnostic tool to improve the timely and diagnostic efficacy in the acute appendicitis, especially in the outpatient and emergency services where high-level diagnostic aids such as images are not available.
Keywords : appendicitis; diagnosis; evaluation; Alvarado score.