Evaluation of Sensitivity And Specificity of Alvarado score In Adults With Acute Appendicitis: A Pilot Study

Appendicitis is defined as inflammation of the appendix, it is one of the most commonest presentation of gastrointestinal tract in younger age group. Although the incidence can be identified in adulthood .It is clinically identified by presentations such as fever, lower abdominal pain, nausea, and vomiting. These are considered as clinical triads of diagnosing appendicitis. Till date the exact cause for the occurance of the disease is not specified and it is believed due to the obstruction of lumen of the appendix by fecal material adds to the pathology. Among various treatment modalities, administration of broad spectrum antibiotics, non –steroidal, anti –inflammatory drugs as well as antipyretics are used affectively in management but surgical exicisi on of appendix is the standard procedure as it is a vestigial organ. Hence the current study will be oriented towards specifying the causative factor as well as to identify better line of management of appendicitis. In this study sensitivity of Alvarado score was 0.36.However the specificity of the test was excellent .positive predictive value (PPV) of Alvarado score was 1 .But negative predictive value (NPV) of the score was 0.61. ROC curve on the left side of the diagonal line area under curve 0.880 was obtained .It is suggestive that Alvarado score is good marker to predict appendicitis .However, the sensitivity and specificity obtained in the graph are matching with that obtained by calculation accordingly Alvarado score > 7 can be specific but may not be a sensitive marker for appendicitis. Alvarado score can be a good tool to diagnose acute appendicitis as it has an acceptable AUC (0.0880).the score also has a good specificity and positive predictive value .It may be an additional diagnostic tool which is at with other diagnostic tools,cost effective as well.