An observational comparative study between Modified Alvarado Score and Tzanaki Score in diagnosis of acute appendicitis

Background: Acute appendicitis is the most common cause of an acute abdomen in young adults. A decision to operate based on clinical suspicion alone can lead to the removal of a normal appendix in 15-25% of cases. Several clinical and laboratorybased scoring systems have been devised to assist diagnosis. Aim: To compare the Diagnostic efficacy of Modified Alvarado score (MAS) and Tzanaki score for acute appendicitis in terms of Sensitivity, Specificity, Positive Predictive value (PPV) and Negative predictive value (NPV). Material and methods: It is a prospective observational study which was conducted at Kasturba hospital affiliated by Kasturba Medical College, Manipal. A total of 75 patients clinically diagnosed to have acute appendicitis were studied who underwent emergency open or Laparoscopic appendectomy from December 2020 to September 2022. Tzanaki and Modified Alvarado scores were obtained for all of them at the time of admission using a pre-prepared Performa and postoperatively specimen was sent for histopathological examination. Results: For MAS Sensitivity, Specificity, PPV, NPV, Diagnostic accuracy were 33%, 83%, 91%, 19%, 41% respectively. For Tzanaki score, Sensitivity, Specificity, PPV, NPV, Diagnostic accuracy were 89%, 58%, 92%, 50%, 84% respectively. Conclusion: Tzanaki scoring is a superior scoring system to decrease negative appendectomy rate when compared to MAS.