ANALYSIS OF DIAGNOSTIC PERFORMANCE OF ALVARADO SCORE AND ULTRASOUND IN PATIENTS SUSPECTED OF HAVING ACUTE APPENDICITIS

Introduction: Acute appendicitis is a surgical emergency and delay in diagnosis can lead to morbidity of the patient. CT despite of being gold standard investigation carry radiation hazards and risk of cancer. Objective: To evaluate diagnostic reliability of Alvarado score and ultrasound in patients who have suspicion of having acute appendicitis to get to a safe diagnosis without radiation exposure. Material and methods: This cross sectional study was conducted in BHU Daiwal, Khushab during December 2018 to June 2019. Results: Using a cut off value of ≥5.5 Alvarado score resulted in sensitivity of 76%, specificity of 93%, accuracy of 84%, PPV 94%, and NPV 73%. US showed a sensitivity of 66%, specificity of 97.6%, accuracy of 79%, PPV 97% and NPV 67%. There was no difference of accuracy between the two modalities. Using both of these modalities can eliminate the use of CT scan. Conclusion: Using Alvarado score as tool of exclusion and US as 1st investigation of choice, a case of acute appendicitis is not only diagnosed correctly but also radiation hazards of CT scan can be eliminated