Comparison between modified alvarado score and Tzanakis score in diagnosing acute appendicitis in Erbil City

Background: The problem of negative appendectomies is an obstacle in medicine because the physicians face difficulties in diagnosing this disease. Therefore, the inclusion of ultrasonography which is a cheap diagnostic tool may enhance the diagnostic dexterity of physicians in acute appendicitis (AA). Objective: This study evaluates and compares the Modified Alvarado Score (MAS) with Tzanakis Score (TZS) in diagnosing AA. Materials and Methods: A prospective study involved 100 patients who were admitted to Rozhhalat hospital in Erbil, following a diagnosis of AA, they had undergone appendectomy during the period from May 2017 to February 2018. All the patients were inquired, examined, and investigated according to MAS and TZS at the same time preoperatively, while the final decision was confirmed by the result of histopathology. Results: Retrocecal appendix was found in 73.15% of patients. Males were 66 cases, while females had 34 cases in a ratio (Male:Female = 1.9:1). The patient's mean of age was 22.667 years (standard deviation of ± 8.03 years). Histological result of 86% of cases was proven to be AA. The accuracy of MAS in diagnosing acute appendicitis was calculated by its sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) which were 0.941, 0.928, 0.987, and 0.723 respectively. While the results of the TZS found that the sensitivity: 0.977, the specificity: 0.928, the PPV: 0.988, and the NPV: 0.867. Results also found that the overall negative appendectomies were 14%. Conclusion: TZS is a cheap, easy, and more practical tool for detecting AA in comparison to MAS