Alvarado score
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The Alvarado score is a clinical scoring system used in the diagnosis of appendicitis. The score has 6 clinical items and 1 laboratory measurement which total 9 points.
The score
- Abdominal pain that migrates to the right iliac fossa
- Anorexia (loss of apetite) or ketones in the urine
- Nausea or vomiting
- Pain on pressure in the right fossa
- Rebound tenderness
- Fever of 37.5°C or more
- >10000 white blood cells per microliter in the serum
A score of less than 5 is not likely appendicitis, 5 or 6 is equivocal, 7 or 8 is probably appendicitis and 9 points means that the patient is highly likely to have appendicitis.
Complementary value
The Alvarado score has a very low sensitivity and a low specificity, especially in women who can have gynecological diseases mimicking appendicitis. The score has been modified to try and find adapted scores with higher clinical importance. Trials have studied the usefulness for the score in guiding the management of patients with pain in the right fossa, for example to see which patients need a CT scan and which patients need surgery.
See also
References
McKay R, Shepherd J. The use of the clinical scoring system by Alvarado in the decision to perform computed tomography for acute appendicitis in the ED. Am J Emerg Med 2007; 25(5): 489-93. PMID 17543650
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
